Ketamine is a dissociative anesthetic agent, with excellent analgesic
properties and a favorable safety profile. Although it acts
predominantly through NMDA receptor antagonism, numerous other molecular
targets have been characterized, rendering anti-inflammatory,
anti-depressant, and thus expanding its scope for new clinical
applications. The noticeable safety of ketamine in children enables its
widespread use in pediatric oncology, chiefly for procedural sedation.
Its value for chronic pain management in children with cancer is being
increasingly recognized but requires more evidence. The topical use of
ketamine is largely in investigational stages.. Rational medical use of
ketamine is largely free from significant long-term neurological side
effects but may have some troublesome short-term effects such as
vomiting, palpitations, urinary retention, and hallucinations. This
review will provide a brief account of the pharmacology of ketamine and
primarily focus on the relevant aspects of ketamine in pediatric
oncology.