Mathilde Adsersen, Maiken Bang Hansen, Mette Asbjoern Neergaard, Per Sjøgren, Mai-Britt Guldin, Mogens Groenvold
The first decade of the Danish Palliative Care Database: improvements and ongoing challenges in the quality and use of specialised palliative care
Acta oncologica (Stockholm, Sweden)
50 years ketamine proven safe anesthetic drug potent analgesic properties active enantiomer sketamine ketamine mostly metabolized norketamine active metabolite dissociative anesthesia sensory inputs may reach cortical receiving areas fail perceived association areas ketamine also enhances descending inhibiting serotoninergic pathway exerts antidepressive effects analgesic effects persist plasma concentrations ten times lower hypnotic concentrations activation nmethyldaspartate nmda receptor plays fundamental role longterm potentiation also hyperalgesia opioidinduced hyperalgesia antagonism nmda receptor responsible ketamines specific properties ketamine decreases wind phenomenon antagonism important nmda channel previously opened glutamate binding use dependence experimentally ketamine may promote neuronal apoptotic lesions usual clinical practice induce neurotoxicity consequences high doses repeatedly administered known cognitive disturbances frequent chronic users ketamine well frontal white matter abnormalities animal studies suggest neurodegeneration potential longterm risk anesthetics neonatal young pediatric patients