Several reasons why ketamine as a neuroplastic agent may have
failed to prevent postoperative delirium: Implications for
future protocols

J 2023

Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols

HORACEK, Jiri, Robert JANDA, Natalie GÖRNEROVA, Lucia JAJCAY, Veronika ANDRASHKO et. al.

Basic information

Original name

Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols

Authors

HORACEK, Jiri, Robert JANDA, Natalie GÖRNEROVA, Lucia JAJCAY and Veronika ANDRASHKO

Edition

Neuroscience Letters, CLARE, Elsevier, 2023, 0304-3940

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30230 Other clinical medicine subjects

Country of publisher

Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.500 in 2022

RIV identification code

RIV/00216224:90249/23:00133576

DOI

http://dx.doi.org/10.1016/j.neulet.2023.137095

UT WoS

000963146600001

Keywords (in Czech)

Ketamine; Postoperative delirium; Anesthesia; Neuroprotective; Neuroplastic; Benzodiazepines; Pharmacological interaction

Keywords in English

Ketamine; Postoperative delirium; Anesthesia; Neuroprotective; Neuroplastic; Benzodiazepines; Pharmacological interaction

Abstract

V originále

Ketamine exerts anti-inflammatory, neuroprotective and neuroplastic activity, therefore it may counteract the neurotoxic processes underlying postoperative delirium. However, the majority of studies in this field failed. We identified several pharmacological reasons why these studies may have failed, together with suggestions of how to remediate them. Among them, the interaction with intravenous general anesthetics exerting the opposite effect on GABA interneurons than ketamine may be of principal importance. We suggest biomarkers which may elucidate the influence of this interaction on the different steps of neuroplastic pathways. We hypothesize that administering ketamine before or after general anesthesia could both prevent the interactions and strengthen the effect of ketamine by timing surgery within the climax of ketamine-induced neuroplastic changes or by stabilizing AMPA receptors. It is vital to deal with these questions because the protocols of ongoing studies are based again on the administration of ketamine during general anesthesia (the major identified pitfall).

Links

90249, large research infrastructures

Name: CZECRIN IV

Citovat

HORACEK, Jiri, Robert JANDA, Natalie GÖRNEROVA, Lucia JAJCAY and Veronika ANDRASHKO. Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols. Neuroscience Letters. CLARE: Elsevier, 2023, vol. 798, February 20213, p. 1-4. ISSN 0304-3940. Available from: https://dx.doi.org/10.1016/j.neulet.2023.137095.

@article{2375839,
   author = {Horacek, Jiri and Janda, Robert and Görnerova, Natalie and Jajcay, Lucia and Andrashko, Veronika},
   article_location = {CLARE},
   article_number = {February 20213},
   doi = {http://dx.doi.org/10.1016/j.neulet.2023.137095},
   keywords = {Ketamine; Postoperative delirium; Anesthesia; Neuroprotective; Neuroplastic; Benzodiazepines; Pharmacological interaction},
   language = {eng},
   issn = {0304-3940},
   journal = {Neuroscience Letters},
   title = {Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols},
   url = {https://www.sciencedirect.com/science/article/pii/S0304394023000496?via%3Dihub},
   volume = {798},
   year = {2023}
}

TY  - JOUR
ID  - 2375839
AU  - Horacek, Jiri - Janda, Robert - Görnerova, Natalie - Jajcay, Lucia - Andrashko, Veronika
PY  - 2023
TI  - Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols
JF  - Neuroscience Letters
VL  - 798
IS  - February 20213
SP  - 1-4
EP  - 1-4
PB  - Elsevier
SN  - 03043940
KW  - Ketamine
KW  - Postoperative delirium
KW  - Anesthesia
KW  - Neuroprotective
KW  - Neuroplastic
KW  - Benzodiazepines
KW  - Pharmacological interaction
UR  - https://www.sciencedirect.com/science/article/pii/S0304394023000496?via%3Dihub
N2  - Ketamine exerts anti-inflammatory, neuroprotective and neuroplastic activity, therefore it may counteract the neurotoxic processes underlying postoperative delirium. However, the majority of studies in this field failed. We identified several pharmacological reasons why these studies may have failed, together with suggestions of how to remediate them. Among them, the interaction with intravenous general anesthetics exerting the opposite effect on GABA interneurons than ketamine may be of principal importance. We suggest biomarkers which may elucidate the influence of this interaction on the different steps of neuroplastic pathways. We hypothesize that administering ketamine before or after general anesthesia could both prevent the interactions and strengthen the effect of ketamine by timing surgery within the climax of ketamine-induced neuroplastic changes or by stabilizing AMPA receptors. It is vital to deal with these questions because the protocols of ongoing studies are based again on the administration of ketamine during general anesthesia (the major identified pitfall).
ER  -

HORACEK, Jiri, Robert JANDA, Natalie GÖRNEROVA, Lucia JAJCAY and Veronika ANDRASHKO. Several reasons why ketamine as a neuroplastic agent may have failed to prevent postoperative delirium: Implications for future protocols. \textit{Neuroscience Letters}. CLARE: Elsevier, 2023, vol.~798, February 20213, p.~1-4. ISSN~0304-3940. Available from: https://dx.doi.org/10.1016/j.neulet.2023.137095.

Detailed Information on Publication Record