Characteristics and efficacy of a noval drug Esketamine
Ketamine was first marketed in European countries in the 1990s,and was initially used as a veterinary anesthetic and an anesthetic in war trauma,but gradually lost its clinical field of vision due to its abuse,psychomotor,cardiovascular system and other adverse reactions.Esketamine,as a dextral isomer of Ketamine,retains pharmacokinetic characteristics compared to its racemic mixture,reaching peak con-centration within one minute after intravenous administration,after which esketamine and its metabolites are excreted mainly through the kidney,with the difference that esketamine has a faster clearance tendency and greater total clearance.In addition,its pharmacokinetics have changed,its sedative and analgesic effects are stronger,the dosage required is smaller,only half of ketamine can achieve the same anesthetic effect,and the hemodynamic changes are more stable,extrapyramidal reactions and other adverse reactions are less severe.In addition,in 2019,Esketamine was approved by the FDA for its major breakthrough in anti-depression results,and since then,it has re-entered the field of clinical anesthesia work as a novel drug.Esketamine can be used as anesthetic induction and maintenance drug,postoperative pain relief drug,nerve blocking adjuvant drug,antidepressant drug and so on.When it is combined,it can reduce the use of propofol and opioids,create intubation conditions faster,reverse respiratory depression caused by opioids,and inhibit the hyperalgesia induced by remifentanil.At the same time,it has multiple effects such as sedation and analgesia,inducing loss of consciousness and for-getting,anti-inflammatory and anti-stress,and improving mood.In this paper,the pharmacological properties and clinical applications of Esketamine as a novel drug,are summarized as follows for clinical reference.
EsketamineAnesthesiaSedation and analgesiaAnti-depressionAdverse reaction
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