Clinical Advantages of Ketamine and NMDA Antagonist Drugs
World Small Animal Veterinary Association Congress Proceedings, 2017
B.D. Wright
Veterinary Anesthesiologist, Integrative Pain Management Specialist

Regulatory update: Human abuse potential has created strong international pressure (China) to increase regulatory control. The commission on narcotic drugs elected not to upgrade the regulation of ketamine to schedule 1 in 2015, but there is still international debate. For more information see the fact sheet that was endorsed by a large number of human and veterinary organizations (in which the WSAVA played an extremely active role) regarding this issue:

Usage update: Ketamine has uses that bridge: anesthetic (inexpensive and widely available in first through third world countries), amnesiac, cardiovascular sparing in intensive care, cerebra-protective, anti-glial activation, neuropathic pain and depression suppressing.

The Global Pain Council of the WSAVA utilizes ketamine extensively in the recommendations for countries where opioid analgesics, and safe non-steroidal analgesics are limited.

Recent human papers evaluating safety in:

1.  Intensive care and cerebral perfusion in the ICU (not increasing ICP)

2.  Reduced neurotoxicity and improved perfusion in neuro-anesthesia

3.  Improved hemodynamics for sedations in ICU

4.  Modification of neuropathic pain and anxiety disorders

Veterinary uses: Two primary considerations: Anesthesia and sedation:

Acute analgesia: NMDA antagonism reduces requirement for opioids, reduced post-operative pain, reduced wind-up at the level of the spinal cord and glia.

The Global Pain Council of the WSAVA utilizes ketamine extensively in the recommendations for countries where opioid analgesics and safe non-steroidal analgesics are limited.

Chronic analgesia: NMDA antagonism mitigates glial hyper-activity and neuropathic pain

1.  Spinal cord injury, brain injury peripheral nerve injury

2.  Chronic OA

Low cost and high margin of safety at sub-anesthetic doses.

Systemic and peripheral applications:

Other NMDA antagonists:

1.  Amantadine 2–5 mg/kg q12–24 hours

2.  Memantine 0.3–0.5 mg/kg q12–24 hours


Speaker Information
(click the speaker's name to view other papers and abstracts submitted by this speaker)

Bonnie D. Wright
Fort Collins, CO, USA

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