Effect of Ketamine Analgosedation on Neurological Outcome in patients with Severe Traumatic Brain Injury: A Randomized Controlled Pilot Study

Phan RD, Bendo AA. Perioperative management of adult patients with severe head injury. In: Cottrell JE, Patel P, editors, Cottrell and Patel’s Neuroanesthesia. Philadelphia: Elsevier; 6th ed, 2017: pp. 326–336.

Ercole A, Menon DK. Traumatic brain injury. In: Matta BF, editor. Core Topics in Neuroanaesthesia and Neurointensive Care. 1st ed. Cambridge University Press; 2011. p. 315–25.

Chapter  Google Scholar 

Oddo M, Crippa IA, Mehta S, Menon D, Payen JF, Taccone FS, et al. Optimizing sedation in patients with acute brain injury. Crit Care. 2016;20:128–31. https://doi.org/10.1186/s13054-016-1294-5.

Article  PubMed  PubMed Central  Google Scholar 

Manley G, Knudson MM, Morabito D, Damron S, Erickson V, Pitts L. Hypotension, hypoxia, and head injury: frequency, duration, and consequences. Arch Surg. 2001;136:1118–23. https://doi.org/10.1001/archsurg.136.10.1118.

Article  PubMed  CAS  Google Scholar 

McHugh GS, Engel DC, Butcher I, et al. Prognostic value of secondary insults in traumatic brain injury: results from the IMPACT study. J Neurotrauma. 2007;24:287–93. https://doi.org/10.1089/neu.2006.0031.

Article  PubMed  Google Scholar 

Gardner AE, Olson BE, Lichtiger M. Cerebrospinal-fluid pressure during dissociative anesthesia with ketamine. Anesthesiology. 1971;35:226–8. https://doi.org/10.1097/00000542-197108000-00029.

Article  PubMed  CAS  Google Scholar 

List WF, Crumrine RS, Cascorbi HF, Weiss MH. Increased cerebrospinal fluid pressure after ketamine. Anesthesiology. 1972;36:98–9. https://doi.org/10.1097/00000542-197201000-00023.

Article  PubMed  CAS  Google Scholar 

Bourgoin A, Albanese J, Wereszczynski N, Charbit M, Vialet R, Martin C. Safety of sedation with ketamine in severe head injury patients: comparison with sufentanil. Crit Care Med. 2003;31:711–7. https://doi.org/10.1097/01.CCM.0000044505.24727.16.

Article  PubMed  CAS  Google Scholar 

Bourgoin A, Albanese J, Leone M, Sampol-Manos E, Viviand X, Martin C. Effects of sufentanil or ketamine administered in target-controlled infusion on the cerebral hemodynamics of severely brain injured patients. Crit Care Med. 2005;33:1109–13. https://doi.org/10.1097/01.ccm.0000162491.26292.98.

Article  PubMed  CAS  Google Scholar 

Chang LC, Raty SR, Ortiz J, Bailard NS, Mathew SJ. The emerging use of ketamine for anesthesia and sedation in traumatic brain injuries. CNS Neurosci Ther. 2013;19:390–5. https://doi.org/10.1111/cns.12077.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Wang X, Ding X, Tong Y, Zong J, Zhao X, Ren H, et al. Ketamine does not increase intracranial pressure compared with opioids: meta-analysis of randomized controlled trials. J Anesth. 2014;28:821–7. https://doi.org/10.1007/s00540-014-1845-3.

Article  PubMed  Google Scholar 

Cohen L, Athaide V, Wickham ME, Doyle-Waters MM, Rose NGW, Hohl CM. The effect of ketamine on intracranial and cerebral perfusion pressure and health outcomes: a systematic review. Ann Emerg Med. 2015;65:43-51.e2. https://doi.org/10.1016/j.annemergmed.2014.06.018.

Article  PubMed  Google Scholar 

Carney N, Totten AM, O’Reilly C, et al. Guidelines for the management of severe traumatic brain injury. Fourth Edition Neurosurgery. 2017;80(1):6–15. https://doi.org/10.1227/NEU.0000000000001432.

Article  PubMed  Google Scholar 

Roberts DJ, Hall RI, Kramer AH, Robertson HL, Gallagher CN, Zygun DA. Sedation for critically ill adults with severe traumatic brain injury: a systematic review of randomized controlled trials. Crit Care Med. 2011;39:2743–51. https://doi.org/10.1097/CCM.0b013e318228236f.

Article  PubMed  CAS  Google Scholar 

Mayberg TS, Lam AM. Ketamine does not increase cerebral blood flow velocity or intracranial pressure during isoflurane/nitrous oxide anesthesia in patients undergoing craniotomy. Anesth Analg. 1995;81:84–9. https://doi.org/10.1097/00000539-199507000-00017.

Article  PubMed  CAS  Google Scholar 

Albanese J, Arnaud S, Rey M, Thomachot L, Alliez B, Martin C. Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation. Anesthesiology. 1997;87:1328–34. https://doi.org/10.1097/00000542-199712000-00011.

Article  PubMed  CAS  Google Scholar 

Schmittner MD, Vajkoczy SL, Horn P, Bertsch T, Quintel M, Vajkoczy P, et al. Effect of fentanyl and S (+)-ketamine on cerebral hemodynamics, gastrointestinal motility, and need of vasopressors in patients with intracranial pathologies a pilot study. J Neurosurg Anesthesiol. 2007;19:257–62. https://doi.org/10.1097/ANA.0b013e31811f3feb.

Article  PubMed  Google Scholar 

Carlson AP, Abbas M, Alunday RL, Qeadan F, Shuttleworth CW. Spreading depolarization in acute brain injury inhibited by ketamine: a prospective, randomized, multiple crossover trial. J Neurosurg. 2018;130(5):1513–9. https://doi.org/10.3171/2017.12.JNS171665.

Article  PubMed  PubMed Central  Google Scholar 

Kolenda H, Gremmelt A, Rading S, Braun U, Markakis E. Ketamine for analgosedative therapy in intensive care treatment of head-injured patients. Acta Neurochir (Wien). 1996;138:1193–9. https://doi.org/10.1007/BF01809750.

Article  PubMed  CAS  Google Scholar 

Caricato A, Tersali A, Pitoni S, De Waure C, Sandroni C, Bocci MG, et al. Racemic ketamine in adult head injury patients use in endotracheal suctioning. Crit Care. 2013;17:R267. https://doi.org/10.1186/cc13097.

Article  PubMed  PubMed Central  Google Scholar 

Grathwohl KW, Black IH, Spinella PC, Sweeney J, Robalino J, Helminiak J, et al. Total intravenous anesthesia including ketamine versus volatile gas anesthesia for combat-related operative traumatic brain injury. Anesthesiology. 2008;109:44–53. https://doi.org/10.1097/ALN.0b013e31817c02e3.

Article  PubMed  CAS  Google Scholar 

Bar-Joseph G, Guilburd Y, Tamir A, Guilburd J. Effectiveness of ketamine in decreasing intracranial pressure in children with intracranial hypertension. J Neurosurg Pediatr. 2009;4:40–6. https://doi.org/10.3171/2009.1.PEDS08319.

Article  PubMed  Google Scholar 

Bhaire VS, Panda N, Luthra A, Chauhan R, Rajappa D, Bhagat H. Effect of combination of ketamine and propofol (Ketofol) on cerebral oxygenation in neurosurgical patients: a randomized double-blinded controlled trial. Anesth Essays Res. 2019;13:643–8. https://doi.org/10.4103/aer.AER_119_19.

Article  PubMed  PubMed Central  Google Scholar 

Chang Y, Lee JJ, Hsieh CY, Hsiao G, Chou DS, Sheu JR. Inhibitory effects of ketamine on lipopoly-saccharide-induced microglial activation. Mediators Inflamm. 2009;2009:705379. https://doi.org/10.1155/2009/705379.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Hertle DN, Dreier JP, Woitzik J, Hartings JA, Bullock R, Okonkwo DO et al. Cooperative Study of Brain Injury Depolarizations (COSBID). Effect of analgesics and sedatives on the occurrence of spreading depolarizations accompanying acute brain injury. Brain, 2012; 135: 2390–2398. https://doi.org/10.1093/brain/aws152

Himmelseher, S., Kochs, E. (2004). Neuroprotection by ketamine. In: Gullo, A. (eds) Anaesthesia, Pain, Intensive Care and Emergency Medicine—A.P.I.C.E.. Springer, Milano. https://doi.org/10.1007/978-88-470-2189-1_19

Zeiler FA, Teitelbaum J, West M, Gillman LM. The ketamine effect on ICP in traumatic brain injury. Neurocrit Care. 2014;21:163–73. https://doi.org/10.1007/s12028-013-9950-y.

Article  PubMed  CAS  Google Scholar 

Hendrikse C, Ngah V, Kallon II, Leong TD, McCaul M. Ketamine as adjunctive or monotherapy for post-intubation sedation in patients with trauma on mechanical ventilation: a rapid review. Afr J Emerg Med. 2023;13(4):313–21. https://doi.org/10.1016/j.afjem.2023.10.002.

Article  PubMed  PubMed Central  CAS  Google Scholar 

Comments (0)

No login
gif