Summary
The present study of the mechanism of action of ketamine on the central nervous system was carried out by the use of chronically implanted chemitrodes in a wide variety of C.N.S. sites in the cat.
Systemic injections of ketamine were found to stimulate all parts of the C.N.S. studied, directly or indirectly, producing a characteristic pattern of high voltage, slow frequency spike discharges alternating with low voltage, fast frequency desynchronized activity. This differs from Corrsen’s original observations of selective action and his concept of dissociative anaesthesia.
Anterior, posterior and lateral hypothalamic injections produced varying degrees of sedation and analgesia associated with cortical spike discharges; globus pallidus injections produced catatonia; lateral geniculate body injections produced restlessness which was intensified by stimulation with light flashes; BSRF injections produced restlessness and even convulsions; and injections into the frontal cortex, the various other nuclei of the thalamus, hippocampus and amygdala did not produce any consistent response.
An explanation of the various manifestations of ketamine anaesthesia is proposed, based on these observations. We believe that the unconsciousness produced is secondary to the induced cortical EEG seizures. This suggests the need for caution in the use of ketamine in convulsive disorders and in your patients with a developing central nervous system.
Réesumé
La présente étude sur le mécanisme ďaction de la kétamine sur le système nerveux central a été faite grâce à ľemploi de chimitrodes implantées chronique-ment dans une grande variété de sites du système nerveux central de chats.
Des injections systémiques de kétamine, ďapres nos résultats, stimulent toutes les parties du S.N.C. éiudiées soit directement, soit indirectement; ce produit provoque un tracé à haut voltage, des influx à fréquence lente alternant avec un bas voltage et une fréquence rapide ďactivité asynchrone. Ceci est différent des observations originales de Corrsen ďaction sélective et de son concept ďanesthé-sie dissociative.
Des injections hypothalamiques antérieures, postéiieures et latéiales ont produit divers degrés de sédation et ďanalgésie associées à des influx corticaux; des injections dans le globus pallidus ont produit de la catatonie; des injections dans le corps géniculé latéral ont produit de ľagitation qui s’est aggravée par la stimulation ďéclairs lumineux; des injections dans le B S R F ont produit de ľagitation, et même des convulsions; des injections dans le cortex frontal, les divers autres noyaux du thalamus, de éhyppocampe et des amygdales n’ont produit au-cune réponse soutenue.
A la suite de ces observations, nous offrons une explication des diverses manifestations de ľanesthésie à la kétamine. Nous croyons que ľinconscience pro-duite est secondaire aux convulsions corticales électro-encéphalographiques produces. A ce compte-là, il s’impose ďêtre prudent lors de ľusage de la kétamine dans les cas de désordres convulsifs et chez les jeunes malades dont le système nerveux se développe.
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References
Corssen, G. &Domino, E.F. Dissociative anesthesia: further pharmacologic studies and first clinical experience with the phencyclidine derivative CI-581. Anesthesia and Analgesia (Cleveland)45: 29–40 (1966).
Corssen, G., Miyasaka, M., &Domino, E.F. Changing concepts in pain control during surgery: dissociative anesthesia with CI-581: a progress report. Anesthesia and Analgesia (Cleveland)47: 746–759 (1968).
Kayama, Y. &Iwama, K. The EEG, evoked potentials, and single-unit activity during ketamine anesthesia in cats. Anesthesiology36: 316–328 (1972).
Winters, W.D. Epilepsy or anesthesia with ketamine (editorial view). Anesthesiology36: 309–312 (1972).
Dawson, B., Michenfelder, J.D., &Theye, R.A. Effects of ketamine on canine cerebral blood flow and metabolism: modification by prior administration of thiopental. Anesthesia and Analgesia (Cleveland)50: 443–447 (1971).
Drury, W.L. &Clark, L.C. Ketamine failure in acute brain injury: a case report. Anesthesia and Analgesia (Cleveland)49: 859–861 (1970).
Janis, K.M. &Wright, W. Failure to produce analgesia with ketamine in two patients with cortical disease. Anesthesiology36: 405–406 (1972).
Dangel, P. Ketamine in der padiatrischen chirurgie, In Kreuscher H. (Ed.). Anesthesiology and Resuscitatopm40: Ketamine, p. 222, New York, Springer.
Walker, A.K.Y. Intramuscular ketamine in a developing country: experience in the British Solomon Islands. Anaesthesia27: 408–414 (1972).
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Wong, D.H.W., Jenkins, L.C. An experimental study of the mechanism of action of ketamine on the central nervous system. Can. Anaesth. Soc. J. 21, 57–67 (1974). https://doi.org/10.1007/BF03004579
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DOI: https://doi.org/10.1007/BF03004579