Ketamine in Neurocritical Care: New Potentials and Perspectives

: Ketamine is an intravenous hypnotic anesthetic that acts primarily by inhibiting N-methyl-D-aspartate (NMDA) receptors, leading to a range of effects, including hypnosis, analgesia, anticonvulsant activity, anti-inflammatory action, and neuroprotection. Initially, there were concerns that ketamine might elevate intracranial pressure. However, these worries have since been dispelled, leading to a renewed consideration of its role in neurocritical care. This evolving understanding has facilitated its increasing use in neurosurgical patients, both in the operating room and intensive care units, where it provides hemodynamic stability and neuroprotective benefits. Additionally, ketamine has shown promise in managing specific neurological conditions such as stroke and refractory seizures, further broadening its clinical applications. This review aims to provide a comprehensive clinical summary of ketamine's usefulness in these settings.