Although anesthetists have long assumed that ketamine's role in neuroanesthesia is limited because of its association with increased intracranial pressure, this article presents a review of recent clinical literature suggesting otherwise. When ketamine is used as an adjuvant anesthetic agent along with mechanical ventilation to maintain normocapnia, ketamine does not have adverse cerebral hemodynamic effects. Furthermore, ketamine possesses a unique pharmacologic profile that provides analgesia, bronchodilation, and sympathetic stimulation, thereby reducing patients' vasoactive agent requirements. Caution must be exercised because of ketamine's action at the N-methyl-D-aspartate receptor (NMDAR), as ketamine may antagonize both neuroprotective and neurodestructive NMDAR-mediated pathways. Still, ketamine may prove to be a safe part of a neuroanesthetic regimen, and it should no longer be considered absolutely contraindicated as a result of its cerebral hemodynamic effects.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
A systematic review of the comparative effects of sound and music interventions for intensive care unit patients' outcomes.
Aust Crit Care
December 2024
Department of Music, Canadian Centre for Ethnomusicology (CCE), Department of Performing Arts, Faculty of Communication and Media Studies, University for Development Studies, Ghana; Department of Music, Faculty of Arts, University of Alberta, 3-98 Fine Arts Building, Edmonton, AB, T6G 2C9, Canada. Electronic address:
Background: Despite syntheses of evidence showing efficacy of music intervention for improving psychological and physiological outcomes in critically ill patients, interventions that include nonmusic sounds have not been addressed in reviews of evidence. It is unclear if nonmusic sounds in the intensive care unit (ICU) can confer benefits similar to those of music.
Objective: The aim of this study was to summarise and contrast available evidence on the effect of music and nonmusic sound interventions for the physiological and psychological outcomes of ICU patients based on the results of randomised controlled trials.
The Historical and Clinical Foundations of the Modern Neuroscience Intensive Care Unit.
World Neurosurg
December 2024
Clinical and Translational Neuroscience Unit, Department of Neurology and Feil Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA. Electronic address:
The subspecialty of neurocritical care has grown significantly over the past 40 years along with advancements in the medical and surgical management of neurological emergencies. The modern neuroscience intensive care unit (neuro-ICU) is grounded in close collaboration between neurointensivists and neurosurgeons in the management of patients with such conditions as ischemic stroke, aneurysmal subarachnoid hemorrhage, intracerebral hemorrhage, subdural hematomas, and traumatic brain injury. Neuro-ICUs are also capable of specialized monitoring such as serial neurological examinations by trained neuro-ICU nurses; invasive monitoring of intracranial pressure, cerebral oxygenation, and cerebral hemodynamics; cerebral microdialysis; and noninvasive monitoring, including the use of pupillometry, ultrasound monitoring of optic nerve sheath diameters, transcranial Doppler ultrasonography, near-infrared spectroscopy, and continuous electroencephalography.
View Article and Find Full Text PDFRelationship between cumulative blood pressure exposure within the early brain injury time window and delayed cerebral ischemia and rebleeding in patients with aneurysmal subarachnoid hemorrhage after aneurysm clipping: a retrospective study.
Neurosurg Rev
December 2024
Department of Neurosurgery, The Second Affiliated Hospital, Chongqing Medical University, 76 Linjiang Road, Chongqing, 400010, People's Republic of China.
Delayed cerebral ischemia, one of the most common complications following aneurysmal subarachnoid hemorrhage, was strongly related to poor patient outcomes. However, there are currently no clear guidelines to provide clinical guidance for post-craniotomy management. Our research aims to explore the association between cumulative blood pressure exposure during the early brain injury phase and the occurrence of delayed cerebral infarction and rebleeding following surgical aneurysm clipping.
View Article and Find Full Text PDFAcute effects of different physical activity on executive function and regulation role of beta oscillation in sedentary youth frontal region.
Sci Rep
December 2024
Key Laboratory of Exercise and Physical Fitness, Ministry of Education, Beijing Sport University, Beijing, China.
Chronic sedentary behavior can have a negative impact on the executive function (EF) of young people. While physical activity (PA) has been shown to improve this phenomenon, the effects of different types of PA on EF vary. In this study, we compared the effects of moderate-intensity continuous training (MICT) (60-70% HRmax, 30 min), body weight training (BWT) (2 sets tabata, 20 min), and mind-body exercise (MBE) (2 sets Yang style shadowboxing, 20 min) on EF in 59 sedentary youth (n = 59, age = 20.
View Article and Find Full Text PDFHistopathology-based near-realistic arterial wall reconstruction of a patient-specific cerebral aneurysm for fluid-structure interaction studies.
Comput Biol Med
December 2024
Department of Applied Mechanics and Biomedical Engineering, Indian Institute of Technology Madras, Chennai, 600036, Tamil Nadu, India. Electronic address:
Background And Objective: Cerebral aneurysms occur as balloon-like outpouchings in an artery, which commonly develop at the weak curved regions and bifurcations. When aneurysms are detected, understanding the risk of rupture is of immense clinical value for better patient management. Towards this, Fluid-Structure Interaction (FSI) studies can improve our understanding of the mechanics behind aneurysm initiation, progression, and rupture.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!