Using millers anaesthesiology book, barasch anaesthesiology book and morgan anesthesia book discuss in detail about Ketamine using this format :- Name of drug/preparation Type of preparation (ampoule/vial/prefilled syringe) Volume of preparation Concentration Total drug content Additional contents/composition Drug class/classification Mechanism of action Onset of action Duration of action Metabolism Elimination/excretion Standard dose Dose modifications in special patients CNS effects Cardiovascular effects Respiratory effects Other systemic effects Clinical uses/indications Advantages Adverse effects/complications Contraindications/cautions Drug interactions Special anaesthesia considerations/pearls Comparison with similar drugs Toxicity/special syndrome associated Management of toxicity Storage requirements Preparation/dilution compatibility Monitoring required during use Safety checks before administration Examiner favourite “why/how” points Recent advances/reversal agents if applicable Summary clinical concluding line
ketamine anesthesia clinical review
- Miller provided the deepest pharmacokinetics (two-compartment model, PK parameters), CNS/CBF/CMR data, and enantiomer pharmacology
- Barash contributed clinical uses (CRPS, depression, acute pain bolus+infusion strategies), cardiovascular mechanism, and the pharmacodynamics table
- Morgan provided the clearest clinical framework: mechanisms, drug interactions, contraindications, comparison table, and practical dosing pearls
- Only IV agent that increases both CBF and CMR (Miller)
- No specific reversal agent exists for ketamine
- Chlorobutanol is neurotoxic — never give neuraxially
- In catecholamine-depleted states, ketamine can precipitate cardiac collapse
- Esketamine (Spravato) is FDA-approved for treatment-resistant depression — a paradigm shift in its clinical use