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Wherefore ketamine?

机译：因此氯胺酮？

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PURPOSE OF REVIEW: Ketamine has been repeatedly reviewed in this journal but novel developments have occurred in the last few years prompting an update. Interesting recent publications will be highlighted against a background of established knowledge. RECENT FINDINGS: In the field of anesthesia, particularly in pediatrics, some contributions have been made concerning intramuscular versus intravenous induction. The need for anticholinergic adjuvants has also been clarified. Neuroapoptosis has been observed in animals and its implications for human subjects are discussed in a general context of neurotoxicity. The most important developments, however, are in the treatment of pain. Neurological and urological side effects strongly question long-term use. Other potentially beneficial effects have also been reported, such as anti-inflammatory and antidepressive effects. There are also indications that ketamine may attenuate postoperative delirium in coronary by-pass patients. SUMMARY: More questions have arisen than have been answered. Some have very grave implications. The issue of neuroapoptosis must be clarified. The long-term effects must be further investigated. On the bright side the effects on postoperative delirium, as well as the anti-inflammatory and antidepressive effects, might open new vistas for an old drug.
机译：审查目的：氯胺酮已在该杂志上进行过多次审查，但最近几年出现了新的发展，促使进行了更新。在已有知识的背景下，将重点介绍近期有趣的出版物。最近的发现：在麻醉领域，特别是在儿科领域，在肌肉内注射与静脉内注射方面已经做出了一些贡献。还已经明确了对抗胆碱能佐剂的需求。已经在动物中观察到神经细胞凋亡，并且在神经毒性的一般背景下讨论了其对人类受试者的影响。然而，最重要的发展是在治疗疼痛方面。神经和泌尿科副作用强烈质疑长期使用。还已经报道了其他潜在的有益作用，例如抗炎和抗抑郁作用。也有迹象表明氯胺酮可以减轻冠状动脉搭桥患者的术后del妄。摘要：出现的问题多于已回答的问题。有些有非常严重的影响。必须阐明神经细胞凋亡的问题。长期影响必须进一步研究。从好的方面说，对术后del妄的作用以及抗炎和抗抑郁作用可能会为旧药开辟新的前景。

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