The effect of ketamine on the respiratory and circulatory systems is different from that of other anesthetics. It is a drug of choice for short-term procedures when muscle relaxation is not required. The use of ketamine in anesthesia reflects its characteristics. It is on the World Health Organization's List of Essential Medicines. Ketamine is also used as a recreational drug, both in powder and liquid form, for its hallucinogenic and dissociative effects. It was regularly used on dogs and horses and extensively used for surgical anesthesia in the Vietnam War. Ketamine was discovered in 1956 and approved for use in the United States in 1970. Ketamine is an NMDA receptor antagonist, and that accounts for most of its actions except the antidepressive effect, the mechanism of which is a matter of much research and debate. Liver and urinary toxicity are common among regular users of high doses of ketamine for recreational purposes.
Psychiatric side effects are frequent as well as raised blood pressure and nausea. However, the antidepressant action of a single administration of ketamine wanes with time, and the effects of repeated use have not been sufficiently studied. At lower, sub-anesthetic doses, ketamine is a promising agent for pain and treatment-resistant depression.
The distinguishing features of ketamine anesthesia are preserved breathing and airway reflexes, stimulated heart function with increased blood pressure, and moderate bronchodilation. It induces dissociative anesthesia, a trance-like state providing pain relief, sedation, and amnesia.
Ketamine is a medication primarily used for starting and maintaining anesthesia.
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