Day Joey, Agrawal Devendra K
Department of Translational Research, College of Osteopathic Medicine of the Pacific, Western University of Health Sciences, Pomona, California 91766 USA.
Anesth Crit Care. 2025;7(2):17-25. Epub 2025 May 5.
Ketamine has unique properties making it a desirable drug to induce general anesthesia during surgery. However, it is typically reserved for children and adolescent patients due to its side effects in adults, including vivid dreams, hallucinations, and confusional states that may be pleasant or distressing. These symptoms may affect patients with post-traumatic stress disorder (PTSD). PTSD is a trauma-related psychological disorder that is mainly characterized by intrusive thoughts, hypervigilance, and re-experiencing of the trauma event. Most of current research focuses on the use of sub-anesthetic doses of ketamine as a treatment for PTSD. Limited information is known about high-dose ketamine use during general anesthesia and the impact this has on patients who suffer from PTSD. A literature review investigating the effects of anesthetic doses of ketamine on PTSD was conducted for this article. Findings suggest that ketamine has dose-related effects on the severity of PTSD. Specifically, low-dose ketamine has the potential as a therapeutic agent in the treatment of PTSD, while high-dose ketamine may cause worsening of PTSD symptoms. This could occur through the increase in psychomimetic symptoms, decrease in plasticity and metaplasticity, and modulation of fear memory systems experienced with anesthetic doses of ketamine. Currently, there are no published research articles directly measuring the effects of high-dose ketamine on PTSD. Further investigation is warranted to understand if anesthetic doses of ketamine worsen PTSD symptoms. This is important because it can help guide the management approach of an anesthesiologist to safely providing anesthesia to PTSD patients.
氯胺酮具有独特的性质，使其成为手术期间诱导全身麻醉的理想药物。然而，由于其在成人中的副作用，包括生动的梦境、幻觉和可能令人愉快或痛苦的意识模糊状态，它通常仅用于儿童和青少年患者。这些症状可能会影响创伤后应激障碍（PTSD）患者。PTSD是一种与创伤相关的心理障碍，主要特征为侵入性思维、过度警觉以及创伤事件的反复体验。目前大多数研究集中在使用亚麻醉剂量的氯胺酮治疗PTSD。关于全身麻醉期间使用高剂量氯胺酮及其对PTSD患者的影响，已知信息有限。本文进行了一项文献综述，调查麻醉剂量的氯胺酮对PTSD的影响。研究结果表明，氯胺酮对PTSD的严重程度具有剂量相关效应。具体而言，低剂量氯胺酮有潜力作为治疗PTSD的药物，而高剂量氯胺酮可能导致PTSD症状恶化。这可能是通过增加拟精神病症状、降低可塑性和反应性可塑性以及调节麻醉剂量氯胺酮所经历的恐惧记忆系统而发生的。目前，尚无直接测量高剂量氯胺酮对PTSD影响的已发表研究文章。有必要进行进一步调查，以了解麻醉剂量的氯胺酮是否会使PTSD症状恶化。这很重要，因为它有助于指导麻醉医生安全地为PTSD患者提供麻醉的管理方法。
