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In austere environments, the provision of effective and safe analgesia and anesthesia is frequently challenging due to difficult terrestrial conditions and limited medical infrastructure. For mountain regions and at high altitude, the use of ketamine as a strong analgesic and anesthetic has been recommended by various experts and recent guidelines. In this chapter, the pharmacological properties of ketamine that are relevant for emergency medical care in the mountains and at high altitude are discussed. A particular focus is set on the hemodynamic and respiratory effects of ketamine as well as ketamine’s influence on the hypoxic ventilatory response (HVR), hypoxic pulmonary vasoconstriction (HVR), and alveolar fluid clearance (AFC).

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Ketamine for Emergency Medicine in the Mountains and at High Altitude

  • 实验方案

  • 发表日期：

    2025年

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  • Marc Moritz Berger,
  • Richard Steffen,
  • Hülya Kursun,
  • Jürgen Knapp

摘要

In austere environments, the provision of effective and safe analgesia and anesthesia is frequently challenging due to difficult terrestrial conditions and limited medical infrastructure. For mountain regions and at high altitude, the use of ketamine as a strong analgesic and anesthetic has been recommended by various experts and recent guidelines. In this chapter, the pharmacological properties of ketamine that are relevant for emergency medical care in the mountains and at high altitude are discussed. A particular focus is set on the hemodynamic and respiratory effects of ketamine as well as ketamine’s influence on the hypoxic ventilatory response (HVR), hypoxic pulmonary vasoconstriction (HVR), and alveolar fluid clearance (AFC).