The Use of Ketamine in Trauma Patients

Abstract

Trauma is one of the leading causes of death worldwide. Stress response secondary to injury occurs at these patients. Because of pain respiratory rate can increase at them. In this regards airway management and hemodynamic stability are important parameters in trauma patients. Ketamine has noncompetitive antagonistic properties on the receptor of N-methyl-D aspartate (NMDA) and it can stimulate brainstem by noradrenalin reuptake inhibition. For that it can be used on monitorization of hemodynamic unstable trauma patients which monitorization is not suitable. We aimed to investigate the frequency of ketamine use in clinical practice in trauma patients and whether it is the preferred agent in traumatic brain injuries and injuries with increased intraocular pressure (IOB) by reviewing the literature.

Keywords

• Trauma,ketamine,analgesia,intracranial pressure,intraocular pressure

Travma Hastalarında Ketamin Kullanımı

Öz

Travma, dünya çapında ölümlerin önde gelen nedenlerinden biridir. Travma hastalarında meydana gelen akut ağrıya sekonder solunum zorluğu, yaralanmaya sekonder stres cevabı oluşabilir. Bu bakımdan travma hastalarında hava yolu yönetimi ve hemodinamik stabilite önemlidir. Ketamin, N-metil-D aspartate (NMDA) reseptörleri üzerinde nonkompetatif antagonistik özelliği ve beyin sapı uyarısı ile nöradrenalin reuptake inhibisyonu sağlar. Bu özelliği ile sempatik etki oluşturarak hemodinamik unstabil travma hastalarında ve monitorizasyonu sağlamanın uygun olmadığı şartlarda (Hastane öncesi afet, savaş yaralanmaları vb.) kullanımı açısından öncelikli ajan olarak literatürde sıkça vurgulanmaktadır. Travma hastalarında klinik pratikte ketaminin yeri, kullanım sıklığı, mortaliteyle doğrudan ilişkili Travmatik Beyin Yaralanmalarında (TBY) ve intraokuler basınç (IOB) artışı ile giden yaralanmalarda geçmişten günümüze tercih edilen ajan haline gelmesini literatür taraması ile aydınlatmayı amaçladık.

Anahtar Kelimeler

• Travma,ketamin,analjezi,intrakranial basınç,intraoküler basınç

Kaynakça

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