Ketamine, a dissociative anesthetic, is used for anesthesia, pain management, and treatment-resistant depression, but safety concerns persist. This review summarizes adverse effects, particularly cardiovascular, neuropsychiatric, and dependency risks. Evidence-based guidelines for administration, dosing, and monitoring are discussed, emphasizing risk-benefit assessments. Future directions include enhanced safety protocols, long-term outcomes, and individualized dosing.
Nebulized ketamine offers a promising alternative for pain management, providing rapid absorption and effective delivery with potentially fewer side effects and better patient compliance due to the smaller volume required for nebulization. A systematic review of nine primary studies indicates that nebulized ketamine is a safe and efficacious treatment for acute pain. However, the evidence is still emerging, and further research is needed to understand its pharmacokinetics, optimal dosing, and efficacy across different populations.