Kedwany Ahmed M, Sayad Reem, Jibril Nada S, Hawash Eslam A, Anis Amna M, John Wadie Danial Nardein, Elsaeidy Ahmed Saad, Kohaf Neveen A
Faculty of Medicine, Assiut University, Assiut, Egypt.
Faculty of Medicine, Menoufia University, Menoufia, Egypt.
Ann Med Surg (Lond). 2025 Jul 18;87(9):5678-5687. doi: 10.1097/MS9.0000000000003580. eCollection 2025 Sep.
Ketamine has emerged as a versatile therapeutic agent with applications spanning anesthesia, pain management, and psychiatric disorders. This review examines ketamine's clinical utility across diverse administration routes, including intravenous, intramuscular, intranasal, and oral, emphasizing the need to individualize dosing regimens. We explore factors influencing ketamine dosing, such as patient characteristics (age, weight, comorbidities), concomitant medications, and desired clinical effects, while balancing efficacy and side effects. The impact of dose, infusion rate, and administration frequency on therapeutic outcomes is analyzed to provide a comprehensive understanding of its clinical implications. The review highlights the critical role of individualized dosing regimens tailored to patient-specific factors. The therapeutic effects of ketamine are dose-dependent, with infusion rate and administration frequency significantly influencing both efficacy and safety. Achieving a balance between clinical benefits and potential side effects remains paramount. There are gaps in knowledge, necessitating for further research into long-term effects, alternative administration routes, and personalized approaches informed by pharmacokinetic variability. Developing standardized, evidence-based protocols and exploring alternative strategies will improve ketamine's therapeutic potential while addressing safety, misuse, and availability concerns.
氯胺酮已成为一种多功能治疗药物，其应用涵盖麻醉、疼痛管理和精神疾病。本综述探讨了氯胺酮在不同给药途径（包括静脉注射、肌肉注射、鼻内给药和口服）中的临床效用，强调了个体化给药方案的必要性。我们探讨了影响氯胺酮给药剂量的因素，如患者特征（年龄、体重、合并症）、伴随用药以及期望的临床效果，同时平衡疗效和副作用。分析了剂量、输注速率和给药频率对治疗结果的影响，以全面了解其临床意义。该综述强调了根据患者特定因素制定个体化给药方案的关键作用。氯胺酮的治疗效果具有剂量依赖性，输注速率和给药频率对疗效和安全性均有显著影响。在临床益处和潜在副作用之间取得平衡仍然至关重要。目前存在知识空白，需要进一步研究长期影响、替代给药途径以及基于药代动力学变异性的个性化方法。制定标准化的、基于证据的方案并探索替代策略，将提高氯胺酮的治疗潜力，同时解决安全性、滥用和可及性问题。
