Ketamine, an N-methyl-D-aspartic acid receptor antagonist that was first discovered in 1962, has become established in anaesthesia providing dose-dependent anaesthetic, sedative, and analgesic effects. Ketamine, however, also acts on a wide range of other cellular targets, resulting in interesting and diverse effects on both physiological and pathological processes. Potential beneficial properties of ketamine include cardiovascular stability for patients undergoing sedation or anaesthesia, analgesia in both acute and chronic pain, bronchodilation in severe refractory asthma, anti-inflammatory properties particularly in sepsis, tumour inhibition, and antidepressant properties with marked ability to reverse suicidal ideation. The reluctance to adopt ketamine into routine practice is likely attributable in part to the stigma and negative reputation associated with its perceived side-effects and potential for abuse. This review explores the diverse properties and therapeutic potentials of ketamine being investigated across different fields whilst also identifying areas for ongoing and future research. Given the diverse range of potential benefits and promising early work, ketamine should be the focus of ongoing research in multiple different specialty areas. This includes areas relevant to anaesthesia and perioperative medicine, such as acute and chronic pain management, ICU sedation, and even tumour suppression in those undergoing surgical resection of malignancies.

中文翻译：

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氯胺酮的多种影响，万事通：叙述性评论。


氯胺酮是一种 N-甲基-D-天冬氨酸受体拮抗剂，于 1962 年首次被发现，现已在麻醉中得到确立，具有剂量依赖性麻醉、镇静和镇痛作用。然而，氯胺酮也作用于广泛的其他细胞靶标，从而对生理和病理过程产生有趣和不同的影响。氯胺酮的潜在有益特性包括接受镇静或麻醉的患者的心血管稳定性、急性和慢性疼痛的镇痛、严重难治性哮喘的支气管扩张、抗炎特性，尤其是败血症、肿瘤抑制和抗抑郁特性，具有显着的逆转自杀意念的能力。不愿将氯胺酮纳入常规实践可能部分归因于与其感知的副作用和滥用可能性相关的耻辱和负面声誉。本综述探讨了不同领域正在研究的氯胺酮的不同特性和治疗潜力，同时也确定了正在进行和未来研究的领域。鉴于多种潜在益处和有前途的早期工作，氯胺酮应成为多个不同专业领域正在进行的研究重点。这包括与麻醉和围手术期医学相关的领域，例如急性和慢性疼痛管理、ICU 镇静，甚至接受手术切除恶性肿瘤的患者的肿瘤抑制。