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Parenteral Anesthetics: Overview01:24

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Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.
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Depolarizing blockers are administered through intravenous injection. Succinylcholine is the most common choice of depolarizing blockers in emergency clinical practices. Although they have a rapid onset, they readily diffuse away from the motor end plate into the extracellular fluid. They are metabolized by enzymes such as liver butyrylcholinesterase and plasma pseudocholinesterases. This produces a short duration of action, typically 5-10 minutes long, unlike nondepolarizing blockers, which...
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Updated: May 26, 2025

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Ketamine-associated upper urinary tract dysfunction: What we know from current literature.

Zhihuan Zheng1,2, Zhongyi Li1, Jiazhe Yuan1

  • 1Department of Urology, Xiangya Hospital, Central South University, Changsha, China.

Asian Journal of Urology
|February 24, 2025
PubMed
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Ketamine abuse can cause upper urinary tract (UUT) dysfunction, leading to symptoms like bladder issues and kidney damage. Understanding its pathogenesis and treatment is crucial for patient recovery.

Keywords:
Clinical characteristicKetaminePathologic mechanismUpper urinary tract dysfunction

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Area of Science:

  • Urology
  • Nephrology
  • Toxicology

Background:

  • Ketamine abuse is increasingly recognized as a cause of significant urinary tract damage.
  • Upper urinary tract (UUT) dysfunction is a serious consequence of chronic ketamine use.

Purpose of the Study:

  • To review current literature on ketamine-associated UUT dysfunction.
  • To outline the pathogenesis and treatment principles for this condition.

Main Methods:

  • A systematic literature search was performed using PubMed and Cochrane databases.
  • Relevant articles published between 2008 and 2023 were included, focusing on ketamine and UUT dysfunction.

Main Results:

  • Eleven papers were analyzed, indicating a concerning prevalence of ketamine-associated UUT dysfunction.
  • Observed effects include bladder dysfunction, vesicoureteral reflux, inflammation, fibrosis, and papillary necrosis.

Conclusions:

  • Ketamine abuse can lead to severe UUT impairment through various mechanisms including oxidative stress and apoptosis.
  • Treatment focuses on UUT protection, improving bladder function, and facilitating social reintegration.
  • Further research is needed to fully elucidate mechanisms and optimize treatment strategies.