Avi A Weinbroum*
Department of Research & Development, Tel Aviv Sourasky Medical Center, IsraelFulltext PDF
Ketamine has proven to be a potent and safe drug for over five decades. While its active enantiomer is S(+)-ketamine, the most widely distributed formulation combines S-ketamine with the weaker R(+) enantiomer. The pharmacology of the drug is well-established. Its main metabolite is not nor ketamine, which is responsible for most of its neuropharmacological activities that result
mostly from the blockade of N-Methyl-D-Aspartate (NMDA) receptors; which decrease the “wind up” phenomenon and enhance the descending inhibition pathways in the spinal cord. Pastpsychomimetic events were related to high-dose protocols that have now been replaced by “sub anesthetic” doses.
Weinbroum AA. Ketamine in Current Clinical Practice: Anything New to Write Home About?. Ann Clin Anesth Res. 2020;4(1): 1028..