Evidence map›Paper›PMID 27028535›Full record

ReviewClinical pharmacokinetics2016

Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy.

Marko A Peltoniemi, Nora M Hagelberg, Klaus T Olkkola, Teijo I Saari

Abstract readReview
PubMed Publisher
In one paragraph

Review in Clinical pharmacokinetics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 273 papers, 15 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
273citing papers in PubMed, 15 pooled it
37.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

273 citing papers in PubMed, 15 syntheses or guidelines pooled it, 629 citations in OpenAlex.

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  2. Safety and tolerance of oral ketamine: A systematic review.Psychiatry and clinical neurosciences · 2026
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  5. Ketamine and other NMDA receptor antagonists for chronic pain.The Cochrane database of systematic reviews · 2025
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213 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

Marko A PeltoniemiDivision of Perioperative Services, Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, University of Turku and Turku University Hospital, Hämeentie 11, PO Box 52, 20520, Turku, Finland. marko.peltoniemi@tyks.fi.
Nora M HagelbergDivision of Perioperative Services, Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, University of Turku and Turku University Hospital, Hämeentie 11, PO Box 52, 20520, Turku, Finland.
Klaus T OlkkolaDepartment of Anaesthesiology, Intensive Care and Pain Medicine, University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4, PO Box 340, 00029, Helsinki, Finland.
Teijo I SaariDivision of Perioperative Services, Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine, University of Turku and Turku University Hospital, Hämeentie 11, PO Box 52, 20520, Turku, Finland.
University of Turku · FIHelsinki University Hospital · FITurku University Hospital · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Ketamine is a phencyclidine derivative, which functions primarily as an antagonist of the N-methyl-D-aspartate receptor. It has no affinity for gamma-aminobutyric acid receptors in the central nervous system. Ketamine shows a chiral structure consisting of two optical isomers. It undergoes oxidative metabolism, mainly to norketamine by cytochrome P450 (CYP) 3A and CYP2B6 enzymes. The use of S-ketamine is increasing worldwide, since the S(+)-enantiomer has been postulated to be a four times more potent anesthetic and analgesic than the R(-)-enantiomer and approximately two times more effective than the racemic mixture of ketamine. Because of extensive first-pass metabolism, oral bioavailability is poor and ketamine is vulnerable to pharmacokinetic drug interactions. Sublingual and nasal formulations of ketamine are being developed, and especially nasal administration produces rapid maximum plasma ketamine concentrations with relatively high bioavailability. Ketamine produces hemodynamically stable anesthesia via central sympathetic stimulation without affecting respiratory function. Animal studies have shown that ketamine has neuroprotective properties, and there is no evidence of elevated intracranial pressure after ketamine dosing in humans. Low-dose perioperative ketamine may reduce opioid consumption and chronic postsurgical pain after specific surgical procedures. However, long-term analgesic effects of ketamine in chronic pain patients have not been demonstrated. Besides analgesic properties, ketamine has rapid-acting antidepressant effects, which may be useful in treating therapy-resistant depressive patients. Well-known psychotomimetic and cognitive adverse effects restrict the clinical usefulness of ketamine, even though fewer psychomimetic adverse effects have been reported with S-ketamine in comparison with the racemate. Safety issues in long-term use are yet to be resolved.

Indexed as

AnalgesicsAnesthesiaAnimalsBiological AvailabilityCentral Nervous SystemChildCytochrome P-450 CYP2B6Cytochrome P-450 CYP3ACytochrome P-450 Enzyme SystemDose-Response Relationship, DrugDrug Administration RoutesHumansKetaminePainReceptors, N-Methyl-D-AspartateAnalgesicsCYP3A protein, humanCytochrome P-450 CYP2B6Cytochrome P-450 CYP3ACytochrome P-450 Enzyme SystemKetaminenorketamineReceptors, N-Methyl-D-Aspartate

Identifiers

PMID27028535
OpenAlexW2322548405

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.