Exploring Ketamine in Traumatic Brain Injury: A Narrative Review of Its Current Emerging Perspectives from Clinical and Preclinical Studies.

The management of traumatic brain injury (TBI) involves various strategies, with sedation playing a pivotal role. Historically, ketamine has been discouraged in TBI management due to concerns regarding its negative impact on cerebral physiology. However, emerging evidence is challenging this perspective. This narrative review was conducted through a comprehensive literature search utilizing key terms such as "ketamine" and "traumatic brain injury." This investigation involved querying multiple medical and scientific databases. Data on the effects of ketamine on intracranial pressure (ICP), cerebral perfusion pressure, systemic hemodynamics, neuroprotection, and neuroinflammation in TBI conditions were collected. Current evidence suggests that ketamine does not significantly affect cerebral hemodynamics compared with other sedatives. Furthermore, preclinical studies have indicated that ketamine exhibits neuroprotective and anti-neuroinflammatory effects. Research endeavors are warranted to explore the effects of ketamine on patients with high-risk ICP and the dose-dependent and combination responses. Moreover, the investigation of the neuroprotective properties of ketamine is encouraged to elucidate its full potential. Reevaluation of ketamine's use is recommended, as it demonstrates comparable efficacy to other sedatives.