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. 2021 Feb 20;73(2):323–345. doi: 10.1007/s43440-021-00232-4

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© The Author(s) 2021

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Ketamine acts as a non-competitive blocker N-methyl-d-aspartate receptor (NMDAR) ion channels. Racemic ketamine contains two optical stereoisomers: S( +) and R(−)-ketamine. Both isomers act as non-competitive blockers, sharing the ability to enter NMDAR ion channels and to exhibit a trapping block. S-ketamine is often preferred in clinical anesthesia because it has a higher affinity for NMDARs than R-ketamine