Stereoselective pharmacokinetics of ketamine and norketamine after racemic ketamine or S-ketamine administration during isoflurane anaesthesia in Shetland ponies

Abstract

Background. The arterial pharmacokinetics of ketamine and norketamine enantiomers after racemic ketamine or S-ketamine i.v. administration were evaluated in seven gelding ponies in a crossover study (2-month interval). Methods. Anaesthesia was induced with isoflurane in oxygen via a face-mask and then maintained at each pony's individual MAC. Racemic ketamine (2.2 mg kg-1) or S-ketamine (1.1 mg kg-1) was injected in the right jugular vein. Blood samples were collected from the right carotid artery before and at 1, 2, 4, 8, 16, 32, 64, and 128 min after ketamine administration. Ketamine and norketamine enantiomer plasma concentrations were determined by capillary electrophoresis. Individual R-ketamine and S-ketamine concentration vs time curves were analysed by non-linear least square regression two-compartment model analysis using PCNonlin. Plasma disposition curves for R-norketamine and S-norketamine were described by estimating AUC, Cmax, and Tmax. Pulse rate (PR), respiratory rate (Rf), tidal volume (VT), minute volume ventilation (VE), end-tidal partial pressure of carbon dioxide (Pe′CO2), and mean arterial blood pressure (MAP) were also evaluated. Results. The pharmacokinetic parameters of S- and R-ketamine administered in the racemic mixture or S-ketamine administered separately did not differ significantly. Statistically significant higher AUC and Cmax were found for S-norketamine compared with R-norketamine in the racemic group. Overall, Rf, VE, Pe′CO2, and MAP were significantly higher in the racemic group, whereas PR was higher in the S-ketamine group. Conclusions. Norketamine enantiomers showed different pharmacokinetic profiles after single i.v. administration of racemic ketamine in ponies anaesthetised with isoflurane in oxygen (1 MAC). Cardiopulmonary variables require further investigation. © The Board of Management and Trustees of the British Journal of Anaesthesia 2007.