Table 7.
| Ketamine | |
|---|---|
| Group | Phencyclidine derivative |
| Mechanism of Action/Pharmacodynamics | Competitive NMDA receptor antagonist Interaction with opioid and muscarinic receptors Na+ Channel |
|
| |
| Effect on ICP | None or decrease |
|
| |
| Neuroprotective effects | Decreased glutamate |
|
| |
| Pharmacokinetics | 20% Bioavailability 40% protein bound Distribution t 1/2 10 minutes Hepatic metabolism Elimination t 1/2 2.5 h |
|
| |
| Advantages | Preserves MAP and CPP |
|
| |
| Disadvantages and major side effects | Early studies ↑ICP, ?epileptogenic Hallucinations/Emergence phenomena |
|
| |
| Dosage | Induction: 2 mg/kg Maintenance: 50 mcg/kg/min |
|
| |
| Other significant facts | |
|
| |
| Appropriate uses in TBI | Haemodynamic instability |