British Journal of Anaesthesia, Vol 76, Issue 6 829-834, Copyright © 1996 by The Board of Management and Trustees of the British Journal of Anaesthesia
S. Ilkjaer, K. L. Petersen, J. Brennum, M. Wernberg and J. B. Dahl
Ketamine reduces nociception by binding noncompetitively to the N-
methyl-D-aspartate (NMDA) receptor, activation of which increases spinal
hypersensitivity. We studied 19 healthy, unmedicated male volunteers, aged
20-31 yr. Burn injuries were produced on the medial surface of the dominant
calf with a 25 x 50 mm rectangular thermode. On 3 separate days, at least 1
week apart, subjects received a bolus of either ketamine 0.15 mg kg-1,
ketamine 0.30 mg kg-1 or placebo, delivered by a mechanical infusion pump
over 15 min. The bolus was followed by continuous infusion of ketamine 0.15
mg kg-1 h-1, ketamine 0.30 mg kg-1 h-1 or placebo, respectively, for 135
min. Ketamine reduced the magnitude of both primary and secondary
hyperalgesia, and also pain evoked by prolonged noxious heat stimulation,
in a dose- dependent manner. In contrast, ketamine did not alter phasic
heat pain perception (perception of transient, painful, thermal stimuli) in
undamaged skin. The analgesic effects of ketamine in the burn injury model
are in agreement with results from experimental studies, and can be
distinguished from those of local anaesthetics and opioids. Side effects
caused by continuous infusion of ketamine 0.15 and 0.30 mg kg-1 h-1 were
frequent but clinically acceptable.
CLINICAL INVESTIGATIONS
Effect of systemic N-methyl-D-aspartate receptor antagonist (ketamine) on primary and secondary hyperalgesia in humans
Department of Anaesthesiology, Skejby University Hospital, DK-8200 Skejby, Aarhus, Denmark; Department of Neurology, Glostrup University Hospital, DK-2600 Glostrup, Copenhagen, Denmark; Department of Anaesthesiology, Glostrup University Hospital, DK-2600 Glostrup, Copenhagen, Denmark
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