Ketamine: Exploring various aspects of the drug
Royal Society of Medicine, 2nd October 2015
In the current context of impending rescheduling of ketamine from Schedule 4 to Schedule 2, and with China petitioning the UN to change it to Schedule 1 (no medical use), this meeting explored the varying uses of ketamine within the medical and veterinary spheres and illustrated its essential role in these environments. Conversely, the use and effects of ketamine as a drug for recreational abuse were shown. Delegates included anaesthetists and veterinary anaesthetists, representatives of the World Federation of Societies of Anaesthesiologists and the World Health Organisation.
Professor Valerie Curran (Professor of Psychopharmacology, University College London) outlined the current legislation regarding ketamine. She then described the short and long term effects of ketamine abuse with studies in humans and rats, and, in contrast, its use as a therapy for depression. Dr Polly Taylor (Consultant in Veterinary Anaesthesia, Taylor Monroe) described the use of ketamine within veterinary anaesthesia and analgesia. She showed its importance in a field where unfamiliar species can be encountered, in some cases where a preanaesthetic examination is performed after a heavy sedation, and the differences in bodyweight between species and within species met is large, making a drug with a wide therapeutic index and minimal undesirable cardiorespiratory effects invaluable. Professor Bill Deakin (Professor of Psychiatry, Director Manchester University) expanded on the use of ketamine as a therapy under consideration for treatment resistant depression in humans, and the use of novel advanced imaging techniques to elucidate the molecular pathways responsible for the effects of ketamine.
The subsequent two speakers, Dr Rachel Craven (Consultant Anaesthetist, University Hospitals Bristol NHS Foundation Trust) and Dr Tamara Banerjee (Anaesthesia and Intensive Care medicine Registrar, The Royal Marsden Hospital NHS Foundation Trust) gave inspiring talks illustrating the vital role of ketamine in anaesthesia, sedation and analgesia for disaster and conflict situations, and in austere environments. Ketamine, being very stable in temperature extremes, is ideal for storage and transport, and given its minimal cardiorespiratory effects, is perfect in situations where there is no oxygen or electricity supply.
At the end of the meeting, I was left in no doubt as to the irreplaceable role ketamine has in anaesthesia, especially in situations where it is the only anaesthetic agent and suitable analgesic available, and was interested to learn of its use in depression: yet another role for a versatile, essential drug.
Interested parties can find more information and lend their support via the World Small Animal Veterinary Association at: www.wsava.org/article/ketamine-please-support-wsava-important-issue
Royal Society of Medicine: https://www.rsm.ac.uk/
ECVAA Resident in Veterinary Anaesthesia and Analgesia, Dick White Referrals, Six Mile Bottom, UK