Ketamine: a misunderstood analgesic?

doi:10.1136/bmj.332.7556.1466

BMJ 2006;332:1466 (24 June), doi:10.1136/bmj.332.7556.1466

Editorial

Ketamine: a misunderstood analgesic?

Clinicians shouldn't be put off by its reputation as an anaestheticand drug of abuse

The first 150 words of the full text of this article appear below.

Ketamine is well known as an intravenous anaesthetic agent withanalgesic properties. It is also becoming well known as a drugof abuse. Less well known, however, is the fact that oral ketamineis a useful analgesic agent in cancer and chronic non-malignantpain. Indeed, its reputation as a drug of abuse may be makingclinicians overcautious about its use for pain relief.

In anaesthetic practice high plasma and brain concentrationsof ketamine result in dissociative anaesthesia, amnesia, a risein arterial pressure, increased heart rate and cardiac output,and raised intracranial pressure with relative preservationof airway reflexes and respiration. Ketamine became establishedfor use in hypovolaemic patients and in difficult locationssuch as battlefields because of its safety. Reports have alsosuggested relatively few serious adverse effects using the oralroute or at subanaesthetic doses,^{1 2} which is also in keepingwith our clinical experience. One of the . . . [Full text of this article]