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, Makassar, Indonesia

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Received: 10 Jan 2023; Published: 31 Mar 2023.

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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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 common.other
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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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  1. Barrett W, Buxhoeveden M, Dhillon S. Ketamine: A versatile tool for anesthesia and analgesia. Curr Opin Anaesthesiol. 2020;33(5):633–8
  2. Iacobucci GJ, Visnjevac O, Pourafkari L, Nader ND. Ketamine: An update on cellular and subcellular mechanisms with implications for clinical practice. Pain Physician. 2017;20(2):E285–301
  3. Quibell R, Fallon M, Mihalyo M, Twycross R, Wilcock A. Ketamine*. J Pain Symptom Manage. 2015;50(2):268–78
  4. Wieruszewski PM, Leung JG, Nelson S. Ketamine use in the intensive care unit. AACN Adv Crit Care. 2018;29(2):101–6
  5. Van BMA, Exline MC, Cape KM, Ryder LP, Phillips G, Ali NA, et al. Increased incidence of clinical hypotension with etomidate compared to ketamine for intubation in septic patients: A propensity matched analysis. J Crit Care. 2017;38:209–14
  6. Radvansky BM, Shah K, Parikh A, Sifonios AN, Le V, Eloy JD. Role of Ketamine in Acute Postoperative Pain Management: A Narrative Review. Biomed Res Int. 2015;2015
  7. Mcnicol ED, Schumann R, Haroutounian S. A systematic review and meta-analysis of ketamine for the prevention of persistent post-surgical pain. Acta Anaesthesiol Scand. 2014;58(10):1199–213
  8. Porter SB, McClain RL, Howe BL, Ardon AE, Mazer LS, Knestrick BM, et al. Perioperative Ketamine for Acute Postoperative Analgesia: The Mayo Clinic-Florida Experience. J Perianesthesia Nurs. 2015;30(3):189–95
  9. Treede RD. The International Association for the Study of Pain definition of pain: as valid in 2018 as in 1979, but in need of regularly updated footnotes. PAIN reports.2018. e643
  10. O’Neil, CL. Pain Management. Dalam : Marie A. Chisholms-Burns, Barbara G. Wells, Terry Schwinghammer, Patrick M. Malone, Jill M.Kolesar, John C.Rotschafer, Joseph T. Di Piro (Eds).Pharmacotherapy Principels & Practice, Edisi ke-7, New York : McGraw-Hill Medical Publishing Division.2008:1089-104
  11. Medicine AP, Hospital MG. Deer’s Treatment of Pain. Deer’s Treat Pain. 2019;199–204
  12. Watkins LR, Martin D, Ulrich P, Tracey KJ, Maier SF. Evidence for the involvement of spinal cord glia in subcutaneous formalin induced hyperalgesia in the rat. Pain. 1997;71(3):225–35
  13. Morgan CJA, Curran HV. Ketamine use: A review. Addiction. 2012;107(1):27–38
  14. Milligan ED, Twining C, Chacur M, Biedenkapp J, O’Connor K, Poole S, et al. Spinal glia and proinflammatory cytokines mediate mirror-image neuropathic pain in rats. J Neurosci. 2003;23(3):1026–40
  15. Mion G, Villevieille T. Ketamine Pharmacology: An Update (Pharmacodynamics and Molecular Aspects, Recent Findings). CNS Neurosci Ther. 2013;19(6):370–80
  16. Peltoniemi MA, Hagelberg NM, Olkkola KT, Saari TI. Ketamine: A Review of Clinical Pharmacokinetics and Pharmacodynamics in Anesthesia and Pain Therapy. Clin Pharmacokinet. 2016;55(9):1059–77
  17. Jouguelet LJ, La CL, Schilling D, Chelly JE. The Use of Intravenous Infusion or Single Dose of Low-Dose Ketamine for Postoperative Analgesia: A Review of the Current Literature. Pain Med (United States). 2015;16(2):383–403
  18. Francisco S. ~ P e r g a m o n SPINAL CORD SUBSTANCE P RECEPTOR. 1996;70(1):201–9
  19. Sung B, Lim G, Mao J. Altered expression and uptake activity of spinal glutamate transporters after nerve injury contribute to the pathogenesis of neuropathic pain in rats. J Neurosci. 2003;23(7):2899–910
  20. Paoletti P, Bellone C, Zhou Q. NMDA receptor subunit diversity: impact on receptor properties, synaptic plasticity and disease. Nature Reviews Neuroscience. 2013; 14:383-400

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