S(+) cetamina em baixas doses: atualização

Ana Luft; Florentino Fernandes Mendes

doi:10.1590/S0034-70942005000400011

Review Article

S(+) cetamina em baixas doses: atualização

Low S(+) ketamine doses: a review

Ana Luft; Florentino Fernandes Mendes

http://dx.doi.org/10.1590/S0034-70942005000400011 Braz J Anesthesiol, vol.55, n4, p.460-469, 2005

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Resumo

JUSTIFICATIVA E OBJETIVOS: A utilização, em baixas doses, de cetamina e de seus isômeros apresenta perspectivas promissoras em anestesia e na analgesia pós-operatória. O objetivo desse trabalho foi revisar as propriedades do uso de baixas doses de cetamina que justifiquem seu uso em anestesia e em analgesia pós-operatória. CONTEÚDO: Vários artigos da literatura sugerem que a cetamina apresenta propriedades de analgesia preemptiva e preventiva em relação à dor pós-operatória, diminuindo o consumo de opióides e melhorando a satisfação dos pacientes. Os fenômenos de tolerância e de hiperalgesia induzidos pela utilização de opióides podem ser atenuados pelo uso da cetamina em baixas doses. Ela diminui o consumo de anestésicos inalatórios e possivelmente apresenta propriedades que podem ser interessantes na proteção da célula nervosa isquêmica. Efeitos promissores, como a neuroproteção e a melhora de resultados, em longo prazo, necessitam de mais estudos. CONCLUSÕES: Em baixas doses a S(+) cetamina apresenta, na maioria dos estudos, efeito preventivo, diminuindo a sensibilização do SNC, a tolerância e a hiperalgesia induzida por opióides, o consumo de anestésicos, o uso de analgésicos e a incidência de efeitos adversos pós-operatórios.

Palavras-chave

ANESTÉSICOS, COMPLICAÇÕES, DOR

Abstract

BACKGROUND AND OBJECTIVES: Low doses of ketamine or isomers are promising possibilities for anesthesia and postoperative analgesia. This study aimed at reviewing major properties of low ketamine doses, which may justify their use in anesthesia and postoperative analgesia. CONTENTS: Literature suggests that ketamine induces preemptive and preventive postoperative pain relief, decreasing opioid consumption and improving patients' satisfaction. Opioid-induced tolerance and hyperalgesia may be minimized with low ketamine doses. Ketamine decreases inhalational anesthetic consumption and may protect ischemic nervous cells. Promising effects, such as neuroprotection and improvement of long-term outcomes, require further studies. CONCLUSIONS: Most studies with low S(+) ketamine doses have shown preventive effects, decreasing central nervous system sensitization, opioid-induced tolerance and hyperalgesia, anesthetic and analgesic consumption, and the incidence of postoperative adverse effects.

Keywords

ANESTHETICS, COMPLICATIONS, PAIN

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S(+) cetamina em baixas doses: atualização

Low S(+) ketamine doses: a review

Ana Luft; Florentino Fernandes Mendes

Resumo

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Abstract

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