Uso da cetamina em pacientes com trauma cranioencefálico: Revisão de literatura

Abstract

The aim of this study was to gather the most current data about the use of ketamine in human and veterinary medicine in cases of traumatic brain injury (TBI) to identify the effects of this medicinal product on intracranial pressure (ICP), cerebral perfusion pressure (CPP) and spreading depolarization (SD), encouraging further studies in veterinary medicine, since there is not enough information about this subject in the knowledge of the author. To conduct this review, were used the search tools for scientific articles as CAPES journals and PubMed since they were available remotely. Traumatic brain injury causes several physiological, immunological, and metabolic changes in the body, including the triggering of a mass membrane depolarization, increased intracranial pressure, and decreased cerebral perfusion pressure. Ketamine is a drug derived from phencyclidine widely used in both human and veterinary medicine for its analgesic and sedative characteristics. Recently, some studies have suggested that, by blocking the action of glutamate (a potentially neurotoxic neurotransmitter), ketamine could have neuroprotective effects, such asa decrease in ICP, an indirect increase in PPC and a decrease in the abnormal propagation of electrical activity. These effects may be useful in trauma patients, leading to a correction of the alterations previously cited. From this study, it is concluded that there is an emerging use of ketamine in medical emergencies, with positive results in hemodynamically unstable patients such as in cases of TBI, being a good option regarding safesedation and analgesia, still there is a need for more research in veterinary medicine to analyze the effect of ketamine in patients with traumatic brain injury and randomized studies with a significant “n” sample to validate the neuroprotective effects suggested in human medicine, establish the ideal dose and report possible adverse effects resulting from the use of this drug .