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In Vogue: Ketamine for Neuroprotection in Acute Neurologic Injury

Bell, Josh D. MD, PhD

doi: 10.1213/ANE.0000000000001856
Neuroscience and Neuroanesthesiology: Narrative Review Article

Neurologic deterioration following acute injury to the central nervous system may be amenable to pharmacologic intervention, although, to date, no such therapy exists. Ketamine is an anesthetic and analgesic emerging as a novel therapy for a number of clinical entities in recent years, including refractory pain, depression, and drug-induced hyperalgesia due to newly discovered mechanisms of action and new application of its known pharmacodynamics. In this focused review, the evidence for ketamine as a neuroprotective agent in stroke, neurotrauma, subarachnoid hemorrhage, and status epilepticus is highlighted, with a focus on its applications for excitotoxicity, neuroinflammation, and neuronal hyperexcitability. Preclinical modeling and clinical applications are discussed.

Published ahead of print January 10, 2017.

From the Department of Anesthesiology, University of Toronto, Toronto, Ontario, Canada.

Published ahead of print January 10, 2017.

Accepted for publication November 30, 2016.

Funding: The author have received funding for the KIND trial from the Canadian Anesthesiologists Society, Physician Services Incorporated, and institutional support from the University of Toronto.

The author declares no conflicts of interest.

Reprints will not be available from the author.

Address correspondence to Josh D. Bell, MD, PhD, Department of Anesthesiology, University of Toronto, Clinician-Investigator Program, 12th floor, 123 Edward St, Toronto, Ontario M5G 1E2, Canada. Address e-mail to Josh.bell@mail.utoronto.ca.

© 2017 International Anesthesia Research Society
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