Review Article

Sedation in Traumatic Brain Injury

Table 7


Ketamine
GroupPhencyclidine derivative

Mechanism of Action/PharmacodynamicsCompetitive NMDA receptor antagonist
Interaction with opioid and muscarinic receptors
Na+ Channel

Effect on ICPNone or decrease

Neuroprotective effectsDecreased glutamate

Pharmacokinetics 20% Bioavailability
40% protein bound
Distribution 1/2 10 minutes
Hepatic metabolism
Elimination 1/2 2.5 h

AdvantagesPreserves MAP and CPP

Disadvantages and major side effectsEarly studies ↑ICP, ?epileptogenic
Hallucinations/Emergence phenomena

DosageInduction: 2 mg/kg
Maintenance: 50 mcg/kg/min

Other significant facts

Appropriate uses in TBIHaemodynamic instability