Ketamine Anirudda Pai MD DNB FRCA

Phencyclidine which is chemically similar to ketamine was introduced into clinical practice in 1958. Although phencyclidine proved useful as an anaesthetic, it produced severe adverse psychological effects in the recovery period. Ketamine, then named C1581, is one of 200 phencyclidine derivatives which were investigate subsequently and proved to be the most promising. It was synthesized as Ketalar in 1962, first used on American soldiers during the Vietnam War and released for civilian use in 1970. It was originally hoped that ketamine would be used as a sole agent for anaesthesia, inducing analgesia, amnesia, loss of consciousness, and immobility. However, because of its adverse psychological effects and the availability of other induction agents, its use diminished rapidly. Recently, the availability of S-(þ)-ketamine has regenerated interest in its clinical use, because it has greater potency and fewer side effects.