DOI: https://doi.org/10.14710/jai.v0i0.51613

Peran Ketamin pada Nyeri di Tingkat Sel

1Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran Universitas Sriwijaya/ RSUP dr. Mohammad Hoesin, Palembang, Indonesia

2Departemen Fisiologi Kedokteran, Fakultas Kedokteran, Universitas Sriwijaya, Palembang, Indonesia

3Departemen Anatomi Kedokteran, Fakultas Kedokteran, Universitas Sriwijaya, Palembang, Indonesia

4 Departemen Fisiologi Kedokteran, Fakultas Kedokteran, Universitas Indonesia, Jakarta, Indonesia

5 Departemen Anestesiologi dan Terapi Intensif, Fakultas Kedokteran, Universitas Hasanuddin/ RSUP Dr. Wahidin Sudirohusodo, Makasar, Indonesia

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Received: 10 Jan 2023; Published: 31 Mar 2023.
Open Access Copyright 2021 JAI (Jurnal Anestesiologi Indonesia)

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Abstract

Ketamin adalah salah satu analgesia yang dapat digunakan baik di dalam atau di luar kamar operasi. Selain efek analgesik, ketamin bersifat bronkodilator, simpatomimetik, dan sedasi yang dapat memberikan kemudahan dalam periode perioperatif. Ketamin berfungsi dalam modulasi sensitisasi sentral, menurunkan toleransi hiperalgesia yang diinduksi opioid, memberikan potensi analgesia opioid dalam dosis hiperalgesia, dan mengurangi eksitasi presinaptik substansi P di sum-sum tulang belakang. Ketamin juga dapat memodulasi reseptor muscarinic acetylcholine yang berpotensi mengurangi tahanan sensitivitas nyeri, up-regulasi reseptor a-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) yang dapat memperbaiki mood dan respons emosional terhadap nyeri. Aktivasi reseptor NMDA menyebabkan influks kalsium, mengaktivasi formasi intraseluler oleh secondary messenger, prostaglandin, dan nitric oxide. Ketamin adalah analog phencyclidine dan bersifat antagonis N-methyl-D-aspartate (NMDA), sehingga efek ketamin dapat mengurangi frekuensi dan waktu pembukaan kanal Ca2+ dan mencegah influks Ca2+. Ketamin juga berperan dalam regulasi respons imun yang berhubungan terhadap sinyal nyeri seperti toll-like receptor. Komponen molekuler yang terlibat pada kerja ketamin di tingkat seluler seperti inhibisi pada reseptor substansi P, inhibisi mAChR, inhibisi reseptor serotonin 1 dan 2, modulasi farmakologi sel glial pada inhibitor glial, L-α-aminoadipate, dan menghambat enzim glial termasuk transporter glutamat (GLT1).

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Mechanisms of Pain and the Role of Ketamine on Pain at the Cell Level
Subject Ketamine; pain; cellular; N-methyl-D-aspartate (NMDA)
Type Research Instrument
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 Research Instrument
Mechanisms of Pain and the Role of Ketamine on Pain at the Cell Level
Subject Cellular; ketamine; N-methyl-D-aspartate (NMDA); pain
Type Research Instrument
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Subject
Type Other
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Keywords: ketamin; n-methyl-d-aspartate (NMDA); nyeri; seluler; substansi P
Funding: -

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Section: Literature Reviews
Language : ID
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