Dissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia

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dc.contributor.authorHahm, Eunice Y.
dc.contributor.authorChamadia, Shubham
dc.contributor.authorLocascio, Joseph J.
dc.contributor.authorPedemonte, Juan C.
dc.contributor.authorGitlin, Jacob
dc.contributor.authorMekonnen, Jennifer
dc.contributor.authorIbala, Reine
dc.contributor.authorEthridge, Breanna R.
dc.contributor.authorColon, Katia M.
dc.contributor.authorQu, Jason
dc.contributor.authorAkeju, Oluwaseun
dc.date.accessioned2025-01-20T23:53:47Z
dc.date.available2025-01-20T23:53:47Z
dc.date.issued2021
dc.description.abstractIntroduction: Ketamine, an anesthetic adjunct, is routinely administered as part of a balanced general anesthetic technique. We recently showed that the acute analgesic and dissociation properties of ketamine are separable to suggest that distinct neural circuits underlie these states. Objective: We aimed to study whether this finding is robust to the substantial neural circuit alterations associated with general anesthesia. Methods: We conducted a single-site, open-label, randomized controlled, cross-over study of sevoflurane and sevoflurane-plus-ketamine (SK) general anesthesia in healthy subjects (n = 12). Before and after general anesthesia, we assessed precalibrated cuff pain intensity and nociceptive pain quality as well as dissociation using the Clinician-Administered Dissociative States Scale (CADSS). For statistical inference, we ran a variation of backward elimination repeated-measures analysis of covariance. Models with CADSS as a covariate term were used to assess whether dissociation mediated the effect of ketamine on pain intensity and quality. Results: Sevoflurane-plus-ketamine general anesthesia was associated with a significant (P = 0.0002) pain intensity decline of 3 (SE, 0.44). There was an order effect for dissociation such that SK was associated with a significant (P = 0.0043) CADSS increase of 17.8 (3.2) when the SK treatment came first. When the pain intensity model was reanalyzed with CADSS as an additional covariate, the effect of CADSS was not significant. These results were also conserved for pain quality. Conclusions: Our findings suggest that the analgesic and dissociation properties of ketamine remain separable despite general anesthesia. Thus, ketamine may be used as a probe to advance our knowledge of dissociation independent pain circuits.
dc.fuente.origenWOS
dc.identifier.doi10.1097/PR9.0000000000000936
dc.identifier.eissn2471-2531
dc.identifier.urihttps://doi.org/10.1097/PR9.0000000000000936
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94995
dc.identifier.wosidWOS:000711826100005
dc.issue.numero2
dc.language.isoen
dc.revistaPain reports
dc.rightsacceso restringido
dc.subjectKetamine
dc.subjectDissociation
dc.subjectPain
dc.subjectAnalgesia
dc.subjectSevoflurane
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleDissociative and analgesic properties of ketamine are independent and unaltered by sevoflurane general anesthesia
dc.typeartículo
dc.volumen6
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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