PURPOSE/AIM

The purpose of this research was to evaluate the possible pharmacological effects of ketamine to suppress, inhibit, or eliminate memories associated with posttraumatic stress disorder (PTSD) in service members wounded in combat. The hippocampus seems to be important for the storage of recent memory. Memories are stored in the following sequence: short-term memory, recent memory, and long-term memory. Short-term memory seems to depend on ongoing neural activity because it is easily disrupted with anesthesia. The use of ketamine allows the patient to feel dissociated from the environment, possibly disrupting recent memories of an unfortunate event such as being wounded in combat. This research seeks to investigate the use of ketamine as the initial intravenous anesthetic agent on service members wounded in combat. The primary research question would be as follows: Can the use of ketamine as the initial intravenous anesthetic agent on military personnel wounded in combat suppress, inhibit, or eliminate memories associated with PTSD?

DESIGN

This literature review will be conducted in preparation for a series of future research studies to evaluate the effectiveness of ketamine and ultimately conduct intervention studies and measure outcomes.

POPULATION/SAMPLE(S) STUDIED

An animal model will be used initially with plans to move into human randomized trials.

METHOD(S)

Initial literature review to better define and evaluate the relationship between ketamine use and memory or decreased PTSD.

DATA ANALYSIS

Systematic review of literature pertaining to any relationships between memory, PTSD, and ketamine.

FINDINGS

The limbic system functions to regulate aggression, sexuality, and motivation. Posttraumatic stress syndrome decreases motivation and possibly increases aggression. Ketamine is a dissociative anesthetic agent that exerts its pharmaceutical effects in the upper areas of the brain to include the limbic system, allowing the patient to feel dissociated from their environment. Short-term memory is easily disrupted with anesthesia. Could the use of ketamine as the initial intravenous anesthetic agent affect the limbic system because of the dissociative effect allowing for a decrease in posttraumatic stress syndrome symptoms in combat-wounded service members?

CONCLUSIONS

Examining the physiological properties of ketamine shows that there is an effect on short-term memory by decreasing the symptoms of PTSD in combat-wounded service members.

RECOMMENDATIONS

Initial literature review reveals that this is a promising field of study to first pursue in animal research leading to possible human studies.

IMPLICATIONS

If ketamine is effective for the suppression of short-term memory in combat-wounded service members, this could possibly lead to early prevention of posttraumatic stress syndrome.

FUNDING

None.

Acknowledgment

The author thanks Maureen Reilly, PhD, CRNA, associate professor, DA/VA Liaison with the US Army Graduate Program in Anesthesia Nursing at the Army Medical Department Center and School at Fort Sam Houston, Texas, for assistance.

Submitted by:

Jeffrey Rumfield, BSN, MPH

MAJ/AN Instructor

Critical Care/Emergency

Nursing Course

Fort Sam Houston, TX

210-916-4924

mailto:[email protected]