Pharmacokinetics and haemodynamics of ketamine in intensive care patients with brain or spinal cord injury.

Abstract:

BACKGROUND:Ketamine is used as an anaesthetic agent for short surgical procedures, and as a sedative and analgesic in intensive care patients. Intensive care patients with brain or spinal cord injury may have physiological changes that could alter the pharmacokinetics of ketamine. The pharmacokinetics of ketamine have been studied in healthy volunteers and in patients undergoing different types of surgery, but no data are available in intensive care patients. METHODS:We determined the pharmacokinetics of ketamine and its active metabolites, norketamine and dehydronorketamine, in 12 intensive care patients with brain or spinal cord injury. The effect of ketamine on haemodynamic variables was also investigated. RESULTS:The total clearance of ketamine, mean (SD), was 36.0 (13.3) ml min(-1) kg(-1), the volume of distribution (Vbeta) was 16.0 (8.6) litre kg(-1), and the elimination half-life was 4.9 (1.6) h. Ketamine did not alter any haemodynamic variables in the patients studied. CONCLUSIONS:Pharmacokinetic variables of ketamine in intensive care patients are greater than in healthy volunteers and in surgical patients. The increase in the volume of distribution is greater than the increase in clearance, resulting in a longer estimated half-life of ketamine in this patient group.

journal_name

Br J Anaesth

authors

Hijazi Y,Bodonian C,Bolon M,Salord F,Boulieu R

doi

10.1093/bja/aeg028

subject

Has Abstract

pub_date

2003-02-01 00:00:00

pages

155-60

issue

2

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)36886-1

journal_volume

90

pub_type

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