(S)-Ketamin pp 17-46 | Cite as

Ketamin in der Inneren Medizin

  • P. Walger


Das klinische Wirkspektrum von Ketamin umfasst die analgetische und anästhetische Komponente. Sympathomimetische und bronchodilatatorische Effekte begünstigen den Einsatz bei Patienten, bei denen kreislaufdepressive Bedingungen vermieden werden müssen oder bei denen eine Bronchoobstruktion antagonisiert oder präventiv verhindert werden muss.


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  1. 1.
    Adams HA, Claußen E, Gebhardt B, Biscoping J, Hempelmann G (1991) Die Analgosedierung katecholaminpflichtiger Beatmungspatienten mit Ketamin und Midazolam. Anaesthesist 40: 238–244PubMedGoogle Scholar
  2. 2.
    Adams HA, Werner C (1997) Vom Razemat zum Eutomer: (S)-Ketamin Renaissance einer Substanz? Anaesthesist 46: 1026–1042PubMedCrossRefGoogle Scholar
  3. 3.
    Adams HA (1997) Endokrine Reaktionen nach A(-)-Ketamin. Anaesthesist 46 (Suppl 1): 30–37CrossRefGoogle Scholar
  4. 4.
    Anand A, Charney DS, Oren DA, Berman RM, Hu XS, Cappiello A, Krystal JH (2000) Attenuation of the neuropsychiatric effects of ketamine with lamotrigine: support for hyperglutamatergic effects of N-methyl-D-aspartate receptor antagonists. Arch Gen Psychiatry 57 (3): 270–276PubMedCrossRefGoogle Scholar
  5. 5.
    Barboni E, Peratoner A, Rocco PL, Sabadini P (1997) Near fatal asthma and psychopathological characteristics: a group-control study. Monaldi Arch Chest Dis 52 (4): 339–342PubMedGoogle Scholar
  6. 6.
    Barnes PJ (1998) Asthma. In: Bone RC (ed) Pulmonary & Critical Care Medicine. Mosby-Year-Book, pp G2–1-G2–15Google Scholar
  7. 7.
    Bellomo R, McLaughlin P, Tai E (1994) Asthma requiring mechanical ventilation: A low-morbidity approach. Chest 105: 891–896Google Scholar
  8. 8.
    Benatar SR (1986) Fatal asthma. N Engl J Med 314 (7): 423–429CrossRefGoogle Scholar
  9. 9.
    Betts EK, Parkin CE (1971) Use of ketamine in an asthmatic child. Anesth Analg Curr Res 50: 420–421Google Scholar
  10. 10.
    Beveridge RC, Grunfeld AF, Hodder RV, Verbeek PR (1996) Guidelines for the emergency management of asthma in adults. CAEP/CTS Asthma Advisory Committee. Canadian Association of Emergency Physicians and the Canadian Thoracic Society. CMAJ 1: 25–37Google Scholar
  11. 11.
    Bister D (1989) Totale intravenöse Anästhesie mit Ketamin und Propofol–Eine Pilotstudie. Fortschr Anaesth 3: 17–24Google Scholar
  12. 12.
    British Asthma Guidelines Coordinating Committee (British Thoracic Society, the National Asthma Campaign and the Royal College of Physicians of London) (1997) British guidelines on asthma management: 1995 review and position statement. Thorax 52 (Suppl 1): 1–24Google Scholar
  13. 13.
    Brown RH, Wagner EM (1999) Mechanisms of bronchoprotection by anesthetic induction agents–Propofol versus Ketamine. Anesthesiology 90 (3): 822–828PubMedCrossRefGoogle Scholar
  14. 14.
    Campbell DA, McLennan G, Coates JR et al. (1994) A comparison of asthma deaths and near-fatal asthma attacks in South Australia. Eur Respi J 7 (3): 490–497CrossRefGoogle Scholar
  15. 15.
    Christ G, Mundigler G, Merhaut C, Zehetgruber M, Kratochwill C, Heinz G, Siostrzonek P (1997) Adverse cardiovascular effects of ketamine infusion in patients with catecholamin-dependent heart failure. Anaesth Intensive Care 25 (3): 255–259PubMedGoogle Scholar
  16. 16.
    Cohen NH, Eigen H, Shaughenessy TE (1997) Common issues in pediatric and adult clinical care: status asthmaticus. Critical Care Clinics 13 (3): 459–476PubMedCrossRefGoogle Scholar
  17. 17.
    Conti G, Dell’Utri D, Vilardi V et al. (1993) Propofol induces bronchodilation in mechanically ventilated chronic obstructive pulmonary disease ( COPD) patients. Acta Anaesthesiol Scand 37: 105–109Google Scholar
  18. 18.
    Corssen G, Domino EF (1966) Dissociative anaesthesia: Further pharmacological studies and first clinical experience with the phencyclidine derivate C1–581. Anesth Analg 45: 29–40PubMedCrossRefGoogle Scholar
  19. 19.
    Dalgarno PJ, Shewan D (1996) Illicit use of ketamine in Scotland. J Psychoactive Drugs 28 (2): 191–199PubMedCrossRefGoogle Scholar
  20. 20.
    Eide PK, Stubhaug A, Stenehjem AE (1995) Central dysesthesia pain after traumatic spinal cord injury is dependent on N-methyl-D-aspartate receptor activation. Neurosurgery 37: 1080–1088PubMedCrossRefGoogle Scholar
  21. 21.
    Engelhardt W (1997) Aufwachverhalten and psychomimetische Reaktionen nach S-(+)-Ketamin. Anaesthesist 46 (Suppl 1): 38–42CrossRefGoogle Scholar
  22. 22.
    Espelin DE, Done AK (1968) Amphetamine poisoning. Effectiveness of chlorpromazine. New Engl J Med 278: 1361–1365, zitiert in Albrecht K (ed) Intensivtherapie akuter Vergiftungen. Ullstein, Berlin Wiesbaden, S 66Google Scholar
  23. 23.
    Feihl F, Perret C (1994) Permissive hypercapnia. How permissive should we be? Am J Resp Crit Care Med 150: 1722–1737PubMedGoogle Scholar
  24. 24.
    Fine PG (1999) Low-dose ketamine in the management of opioid nonresponsive terminal cancer pain. J Pain Symptom Manage 17 (4): 296–300PubMedCrossRefGoogle Scholar
  25. 25.
    Fisher M (1977) Ketamine hydrochloride in severe bronchospasm. Anaesthesia 32: 771–772CrossRefGoogle Scholar
  26. 26.
    Forsyth AJM (1995) Ecstasy and illegal drug design: a new concept in drug use. International J Drug Policy 6: 193–209Google Scholar
  27. 27.
    Freye E, Knüfermann V (1994) Keine Hemmung der intestinalen Motilität nach Ketamin-/Midazolamnarkose. Ein Vergleich zur Narkose mit Enfluran and Fentanyl/Midazolam. Anaesthesist 43: 87–91Google Scholar
  28. 28.
    Gammon BG, Strickland JH, Kennedy JI, Young KR (1995) Mechanical ventilation: A review for the internist. AJM 99: 553–562Google Scholar
  29. 29.
    Gateau O, Bourgain JL, Gaudy JH, Benveniste J (1989) Effects of ketamine on isolated human bronchial preparations. Br J Anaesth 63: 692–695PubMedCrossRefGoogle Scholar
  30. 30.
    Graven-Nielsen T, Aspegren Kendall S, Henriksson KG, Bengtsson M, Sorensen J, Johnson A, Gerdle B, Arendt-Nielsen L (2000) Ketamine reduces muscle pain, temporal summation, and referred pain in fibromyalgia patients. Pain 85 (3): 483–491PubMedCrossRefGoogle Scholar
  31. 31.
    Handa F (2000) Effects of clonidine premedication on side effects of intravenous ketamine anaesthesia: a randomized, double-blind, placebo-controlled study. J Clin Anesth 12 (1): 19–24PubMedCrossRefGoogle Scholar
  32. 32.
    Hemming A, MacKenzie I, Finfer S (1994) Response to ketamine in status asthmaticus resistant to maximal medical treatment. Thorax 49: 90–91PubMedCrossRefGoogle Scholar
  33. 33.
    Hersack RA (1994) Ketamine’s psychological effects do not contraindicate its use based on a patient’s occupation. Aviat Space Environ Med 65 (11): 10411046Google Scholar
  34. 34.
    Hill GE (1999) Ketamine inhibits agonist-induced cAMP accumulation increase in human airway smooth muscle cells. Can J Anaesth 46 (12): 1172–1177PubMedCrossRefGoogle Scholar
  35. 35.
    Himmelseher S (1998) The clinical use of S-(+)-ketamine–a determination of its place. Anästhesiol Intensivmed Notfallmed Schmerzther 33 (12): 764–770PubMedCrossRefGoogle Scholar
  36. 36.
    Hirota K, Hashimoto Y, Sakai T, Sato T, Ishihara H, Matsuki A (1998) In vivo spasmolytic effect of ketamine and adrenaline on histamin-induced airway constriction. Direct visualization method with a superfine fibreoptic bronchoscope. Acta Anaesthesiol Scand 42 (2): 184–188PubMedCrossRefGoogle Scholar
  37. 37.
    Hirota K, Sato T, Rabito SF, Zsigmond EK, Matsuki A (1996) Relaxant effect of ketamine and its isomers on histamine-induced contraction of tracheal smooth muscle. Br J Anaesth 76 (2): 266–270PubMedCrossRefGoogle Scholar
  38. 38.
    Hirshman CA, Downes H, Farbood A, Bergman NA (1979) Ketamine block of bronchospasm in experimental canine asthma. Br J Anaesth 51 (8): 713–718PubMedCrossRefGoogle Scholar
  39. 39.
    Howton JC, Rose J, Duffy S, Levitt MA (1996) Randomized, double-blind, placebo-controlled trial of intravenous ketamine in acute asthma. Ann Emerg Med 27 (2): 170–175PubMedCrossRefGoogle Scholar
  40. 40.
    Johnson AJ, Nunn AJ, Somner AR, Stableforth DE, Stewart CJ (1984) Circumstances of death from asthma. Br Med J (Clin Res Ed) 288 (6434): 1870–1872CrossRefGoogle Scholar
  41. 41.
    Jungck E, Klöss Th, Polke K, Roewer N (1981) Behandlung des therapieresistenten Status asthmaticus mit Ketamin. Notfallmedizin 7: 447–457Google Scholar
  42. 42.
    Kaube H, Herzog J, Kaufer T, Dichgans M, Diener HC (2000) Aura in some patients with familial hemiplegic migraine can be stopped by intranasal ketamine Neurology 12; 55 (1): 139–141Google Scholar
  43. 43.
    Ketamine Hydrochloride (001604) (2001) In: Mosby’s GenRx,11th ed. Mosby, IncGoogle Scholar
  44. 44.
    Kinnula V, Nurmela T, Liippo K, Tala E, Huhti E (1998) Fatal asthma in two regions of Finland Ann Clin Res 20 (3): 189–194Google Scholar
  45. 45.
    Klepstad P, Borchgrevink PC (1997) Four years’ treatment with ketamine and a trial of dextrometorphan in a patient with severe post-herpetic neuralgia. Acta Anaesthesiol Scand 41 (3): 422–426PubMedCrossRefGoogle Scholar
  46. 46.
    Leatherman JW (1996) Mechanical ventilation in obstructive lung disease. Clinics in Chest Medicine 17 (3): 577–590PubMedCrossRefGoogle Scholar
  47. 47.
    Lin RY, Rehman A (1995) Clinical characteristics of adult asthmatics requiring intubation. J Med 26 (5–6): 261–277PubMedGoogle Scholar
  48. 48.
    Lundy PM, Gowdey CW, Colhoun EH (1974) Tracheal smooth muscle relaxant effect of ketamine. Br J Anaesth 46: 333–336PubMedCrossRefGoogle Scholar
  49. 49.
    MacDonald JB, MacDonald ET, Seaton A, Williams DA (1976) Asthma death in Cardiff 1963–74: 53 death in hospital. Br Med J 2 (6038): 721–723PubMedCrossRefGoogle Scholar
  50. 50.
    MacDonald JB, Seaton A, Williams DA (1976) Asthma death in Cardiff 1963–74: 90 death outside hospital. Br Med J 1 (6024): 1493–1495PubMedCrossRefGoogle Scholar
  51. 51.
    Max MB, Byas-Smith MG, Gracely RH, Bennet G (1995) Intravenous infusion of the NMDA Antagonist, Ketamine, in chronic posttraumatic pain with allodynia: a double-blind comparison to Alfentanil and Placebo. Clinical Neuropharmacology 18: 360–368PubMedCrossRefGoogle Scholar
  52. 52.
    Mayer M, Ochmann O, Doenicke A, Angster R, Suttmann H (1990) Einfluss einer Propofol-Ketamin-Narkose auf Kreislaufverhalten and Analgesie im Vergleich mit Propofol-Fentanyl. Anaesthesist 39: 609–616PubMedGoogle Scholar
  53. 53.
    McFadden ER Jr, Warren EL (1997) Observations on asthma mortality. Ann Intern Med 127 (2): 142–147PubMedGoogle Scholar
  54. 54.
    Milgrom H, Bender B (1997) Nonadherence to asthma treatment and failure of therapy. Curr Opin Pediatr 9 (6): 590–595PubMedCrossRefGoogle Scholar
  55. 55.
    Molfino NA, Nannini LJ, Martelli AN, Slutsky AS (1991) Respiratory Arrest in near fatal Asthma N Engl J Med 324 (5): 285–288Google Scholar
  56. 56.
    Nakazawsa T, Kawakami Y, Sudo M, Kobayashi S, Suetsugu S, Nakajima S, Yamakido M, Nagano H (1998) Trends of asthma death among adults in Japan 1992–1994. Analysis of 313 cases reported questionnaires sent to hospitals with more than 100 beds. Arerugi 47 (1): 41–47PubMedGoogle Scholar
  57. 57.
    Nikolajsen L, Hansen CL, Nielsen J, Keller J, Arendt-Nielsen L, Jensen TS (1996) The effect of ketamine on phantom pain: a central neuropathic disorder maintained by peripheral input. Pain 67 (1): 69–77PubMedCrossRefGoogle Scholar
  58. 58.
    Nikolajsen L, Hansen PO, Jensen TS (1997) Oral ketamine therapy in the treatment of postamputation stump pain. Acta Anaesthesiol Scand 41 (3): 427–429PubMedCrossRefGoogle Scholar
  59. 59.
    Orser BA, Pennefather PS, MacDonald JF (1997) Multiple mechanisms of ketamine blockade of n-methyl-d-aspartate receptors. Anesthesiology 86 (4): 903–918PubMedCrossRefGoogle Scholar
  60. 60.
    Pabelick CM (1997) Stereospecific effects of ketamine enantiomers on canine tracheal smooth muscle. Br J Pharmacol 121 (7): 1378–1382PubMedCrossRefGoogle Scholar
  61. 61.
    Park GR, Manara AR, Mendel L, Batemen PE (1987) Ketamine infusion: its use as a sedative, inotrope and bronchodilatator in a critically ill patient. Anaesthesia 42 (9): 980–983PubMedCrossRefGoogle Scholar
  62. 62.
    Persson J, Hasselstrom J, Wiklund B, Heller A, Svensson JO, Gustafsson LL (1998) The analgetic effect of racemic ketamine in patients with chronic ischemic pain due to lower extremity arteriosclerosis obliterans. Acta Anaesthesiol Scand 42 (7): 750–758PubMedCrossRefGoogle Scholar
  63. 63.
    Persson J (1999) Ketamine antagonises alfentanil-induced hypoventilation in healthy male. Acta Anaesthesiol Scand 43 (7): 744–752PubMedCrossRefGoogle Scholar
  64. 64.
    Phencyclidines (Ketamine) (2000) In: Miller RD (ed) Anesthesia, 5th ed. Churchill Livingstone, p 240–245Google Scholar
  65. 65.
    Practical Guide for the Diagnosis and Management of Asthma. National Institutes of Health Consensus Development Conference Consensus Statement (1997) from: National Heart, Lung, and Blood Institute, National Asthma Education and Prevention Program. Expert Panel Report 2: Guidelines for the Diagnosis and Management of Asthma. National Institutes of Health pub no 97–4051. Bethesda, MDGoogle Scholar
  66. 66.
    Practice Parameters for Diagnosis and Treatment of Asthma (1995) J Allergy Clin Immunol 96 (5): 714–870Google Scholar
  67. 67.
    Rabben T, Skjelbred P, Oye I (1999) Prolonged analgesic effect of ketamine, an N-Methyl-D-Aspartate Receptor Inhibitor, in patients with chronic pain. J Pharmacol Exp Ther 289: 1060–1066PubMedGoogle Scholar
  68. 68.
    Rea HH, Scragg R, Jackson R, Beaglehole R, Fenwick J Sutherland DC (1986) A case-control study of death from asthma. Thorax 41 (11): 833–839Google Scholar
  69. 69.
    Richards GN, Kolbe J, Fenwick J, Rea HH (1993) Demographic characteristics of patients with severe life threatening asthma: comparison with asthma deaths. Thorax 48 (11): 1105–1109PubMedCrossRefGoogle Scholar
  70. 70.
    Roberts JR (1998) Clinical procedures in emergency medicine, 3rd ed. W.B. Saunders, Philadelphia, pp 521–533Google Scholar
  71. 71.
    Robertson CF, Rubinfeld AR, Bowes G (1990) Deaths from asthma in Victoria: a 12-month survey. Med J Aust 152 (10): 511–517PubMedGoogle Scholar
  72. 72.
    Sato T (1997) The effect of ketamine on guinea pig airway smooth muscle is epithelium-independent. Anesth Analg 84 (3): 641–647PubMedGoogle Scholar
  73. 73.
    Schwender D, Djonlagic H (1990) Analgosedierung mit Ketamin in der Respiratortherapie des akuten, therapie-resistenten Asthma bronchiale. Fortschr Anästh 4: 44 47Google Scholar
  74. 74.
    Shehan D, Dalgarno PJ, King LA (1996)… such as ketamine. BMJ 313: 424Google Scholar
  75. 75.
    Sheref SE (1985) Ketamine and bronchospasm (letter). Anaesthesia 40: 701–702PubMedCrossRefGoogle Scholar
  76. 76.
    Sly RM (1988) Mortality from asthma, 1979–1984. J Allergy Clin Immunol 82 (5 Pt 1): 705–717PubMedCrossRefGoogle Scholar
  77. 77.
    Somerville M, Williams EM, Pearson MG (1995) Asthma deaths in Mersey region 1989–1990. J Public Health Med 17 (4): 397–403PubMedGoogle Scholar
  78. 78.
    Sorensen J, Bengtsson A, Backman E, Henriksson KG, Bengtsson M (1995) Pain analysis in patients with fibromyalgia. Effects of intravenous morphine, lidocaine, and ketamine. Scand J Rheumatol 24 (6): 360–365PubMedCrossRefGoogle Scholar
  79. 79.
    Strube PJ, Hallam PL (1986) Ketamine by continuous infusion in status asthmaticus. Anaesthesia 41: 1017–1019PubMedCrossRefGoogle Scholar
  80. 80.
    Sudo M, Kobayashi H, Nakagawa T et al. (1996) A comparison of asthma deaths and near-fatal asthma attacks. Arerugi 45 (12): 1262–1269PubMedGoogle Scholar
  81. 81.
    Tough SC, Green FH, Paul JE, Wigle DT, Butt JC (1996) Sudden Death from asthma in 108 children and young adults. J Asthma 33 (3): 179–188PubMedCrossRefGoogle Scholar
  82. 82.
    Turnpenny PD, Nash SF (1991) Ketamine in severe acute asthma (letter). Arch Emerg Med 8: 291–292PubMedGoogle Scholar
  83. 83.
    Tuxen DV, Lane S (1987) The Effects of ventilatory pattern on hyperinflation, airway pressures, and circulation in mechanical ventilation of patients with severe air-flow obstruction. Am Rev Respir Dis 136: 872–879PubMedCrossRefGoogle Scholar
  84. 84.
    Tuxen DV, Williams TJ, Scheinkestel CD, Czarny D, Bowes G (1992) Use of a measurement of pulmonary hyperinflation to control the level of mechanical ventilation in patients with severe asthma. Am Rev Respir Dis 146: 11361142Google Scholar
  85. 85.
    Vives L, Fayas S, Fischer MA et al. (1997) Fatal asthma. Description and study of risk factors, in the heart of an asthmatic population followed by the College of Pneumology of the Southwest. Rev Mal Respir 4 (6): 473–480Google Scholar
  86. 86.
    Walls RM (1998) Airway Management. In: Rosen P (ed) Emergency medicine: concepts and clinical practice, 4th ed., Mosby-Year Book, pp 2–24Google Scholar
  87. 87.
    Warncke T, Stubhaug A, Jorum E (1997) Ketamine, an NMDA receptor antagonist, suppresses spatial and temporal properties of burn-induced secondary hyperalgesia in man: a double-blind, cross-over comparison with morphine and placebo. Pain 72 (1–2): 99–106PubMedCrossRefGoogle Scholar
  88. 88.
    Wettengel R, Berdel D, Hofmann D et al. (1998) Asthmatherapie bei Kindern und Erwachsenen Empfehlungen der Deutschen Atemwegsliga in der Deutschen Gesellschaft für Pneumologie. Medizinische Klinik 93 (11): 639–650PubMedCrossRefGoogle Scholar
  89. 89.
    Wiedemann B (1997) Ketamin zur Therapie chronischer Schmerzen–Metaanalyse. Der Schmerz 11: 276–281PubMedCrossRefGoogle Scholar
  90. 90.
    Williams TJ, Tuxen DV, Scheinkestel CD (1992) Risk factors for morbidity in mechanically ventilated patients with acute severe asthma. Am Rev Respir Dis 146: 607–615PubMedGoogle Scholar
  91. 91.
    Wobig EK, Rosen P (1996) Death from asthma: rare but real. J Emerg Med 14 (2): 233–240PubMedCrossRefGoogle Scholar
  92. 92.
    Youssef-Ahmed MZ, Silver P, Nimkoff L, Sagy M (1996) Continuous infusion of ketamine in mechanically ventilated children with refractory bronchospasm. Intensive Care Medicine 22 (9): 972–976PubMedCrossRefGoogle Scholar
  93. 93.
    Zickmann B (2000) S-(+)-ketamine versus ketamine racemic mixtures: hemodynamic studies. Anästhesiol Intensivmed Notfallmed Schmerzther 35 (5): 333–339PubMedCrossRefGoogle Scholar

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