PMID: 9163277Mar 1, 1997Paper

Recovery and psychomimetic reactions following S-(+)-ketamine

Der Anaesthesist
W Engelhardt

Abstract

Ketamine is a racemic mixture containing equal parts of S-(+)-ketamine and R-(-)-ketamine. Their potency relation is approximately 4:1. In early human studies S-(+)-ketamine was presumed to produce the desired anaesthetic effects and R-(-)-ketamine the undesired psychic emergence reactions. Therefore, ketamine was compared in a number of randomised studies in volunteers and patients with racemic ketamine. This review addresses the impact of S-(+)-ketamine on recovery from anaesthesia, incidence and content of vivid dreams, and other side effects. The dose relation applied in the studies was 1:2. With only one exception, the recovery phase was clearly shorter after S-(+)-ketamine compared to racemic ketamine irrespective of its application as a single bolus, a bolus followed by continuous infusion, or an intramuscular injection. However, the incidence of psychic emergence reactions was lower after S-(+)-ketamine in only a single study. In conclusion, S-(+)-ketamine should be always combined with a hypnotic or sedative drug in clinical anaesthesia.

Citations

May 16, 2013·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Joakim JohanssonHenrik Zetterström
Feb 24, 2001·Journal of Psychoactive Drugs·K L Jansen
May 25, 2004·Anesthesia and Analgesia·W NagelsE Vandermeersch
Oct 3, 2006·Current Opinion in Anaesthesiology·L E Mather, S R Edwards
Jan 26, 2021·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·Torsten PassieMatthias Karst
May 10, 2008·Veterinary Anaesthesia and Analgesia·Christoph PeterbauerClaudia Spadavecchia
Jul 22, 2014·Veterinary Anaesthesia and Analgesia·Daniela CasoniChiara Adami

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