The myth and mending of ketamine

Ketamine [2-(O-chlorophenyl)-2-methylamino cyclohexanone] is a widely misunderstood drug. In approximately 50 years since it was developed, it has flitted in and out of popularity. Although ketamine is successfully used for analgesia in emergency medicine and the developing world, it is still unfairly demonized in some circles. With the continued evolution of differing operational models within prehospital care, we should be attempting to dispel some of the myths surrounding ketamine and highlight reasons why it may be a safe and effective option within this context.

Ketamine, a chemical derivative of phencyclidine (PCP), was first synthesized by Calvin Lee Stevens, Professor of organic chemistry at Wayne State University. Initially evaluated under the clinical number CI-581, the pharmacological actions were tested on volunteers from the population of Jackson Prison, Michigan in 1964. It was shown to be an effective analgesic and anaesthetic agent that gave patients a feeling of being ‘disconnected’ from the environment. The term ‘dissociative anaesthetic’ was coined by Toni Domino, the wife of one of the lead researchers, to describe the clinical effects of the drug (Domino, 2010).