Evidence for Central Adrenergic Action of Ketamine: Report of a Case

INCE the introduction of ketamine (CIS 581) by Domino and associates,l numerous reports have appeared, to explain various aspects of the cardiovascular responses (increased cardiac output, hypertension, tachycardia, little or no change in peripheral resistance) observed with this phencyclidine derivative. Epidural anesthesia; beta-adrenergic, alpha-adrenergic, and ganglionic blocking drugs; cross-circulation and catecholamine metabolism have been used to identify the effector components of such cardiovascular responses, but the mechanism is not yet clear. Some of the evidence previously presented is inferential, some is positive experimental evidence, and some is negative experimental evidence.