PMID: 9163275Mar 1, 1997Paper

Clinical significance of S-(+)-ketamine

Der Anaesthesist
G Hempelmann, D F Kuhn

Abstract

Among anaesthetic drugs, ketamine occupies a special position. biochemically, ketamine is a racemate consisting of equal shares of two optical enantiomers. Pharmacological investigations show differences between those enantiomers in both qualitative and quantitative properties. Furthermore, clinical superiority of S-(+)-ketamine has been described in different therapeutic studies with regard to anaesthetic potency, the extent of analgesia, effects and side effects during and after the operation, and undiserable psychological dysfunction. On a neuropharmacological basis, the clinical superiority of S-(+)-ketamine is due to its effect on NMDA receptors in central nervous tissue, opioid receptors on both central and peripheral levels, and noradrenergic, dopaminergic, and serotoninergic mechanisms. The main problems associated with the ketamine racemate in clinical use are desirable psychological dysfunction and a prolonged period of arousal. There are grounds for the assumption that the use of S-(+)-ketamine will minimise those problems without reducing anaesthetic potency or restricting the advantages of ketamine anaesthesia.

Citations

Feb 14, 2008·Der Anaesthesist·Claudia TimmC Maier
Jun 16, 2006·Der Anaesthesist·M LangeM Westphal
Oct 3, 2006·Current Opinion in Anaesthesiology·L E Mather, S R Edwards
Jul 7, 2014·Brazilian Journal of Anesthesiology·Slobodan MihaljevicMarko Cacic
Aug 7, 2014·Revista brasileira de anestesiologia·Slobodan MihaljevicMarko Cacic
Jun 30, 2016·Therapeutic Advances in Psychopharmacology·John MullerSrinivas Pentyala
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