Effect of ketamine combined with lidocaine in pediatric anesthesia.

Autor: Fang H; Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang, China.; Department of Anesthesiology, Guizhou University People's Hospital, Guiyang, China., Li HF; Department of Anesthesiology, West China Second University Hospital, Sichuan University, Chengdu, China., Yang M; Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang, China.; Department of Anesthesiology, Guizhou University People's Hospital, Guiyang, China., Zhang FX; Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang, China.; Department of Anesthesiology, Guizhou University People's Hospital, Guiyang, China., Liao R; Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China., Wang RR; Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China., Wang QY; Department of Anesthesiology, West China Hospital, Sichuan University, Chengdu, China., Zheng PC; Guizhou University Research Center for Analysis of Drugs and Metabolites, Guizhou University, Guiyang, China., Zhang JP; Department of Anesthesiology, Guizhou Provincial People's Hospital, Guiyang, China.; Department of Anesthesiology, Guizhou University People's Hospital, Guiyang, China.
Jazyk: angličtina
Zdroj: Journal of clinical laboratory analysis [J Clin Lab Anal] 2020 Apr; Vol. 34 (4), pp. e23115. Date of Electronic Publication: 2019 Nov 15.
DOI: 10.1002/jcla.23115
Abstrakt: Background: We conducted a randomized clinical trial to determine whether adjunctive lidocaine diminishes the incidence of adverse effects in pediatric patients sedated with ketamine.
Methods: This case-control study involved 586 consecutive pediatric patients necessitating anesthesia. Then systolic blood pressure, heart rate, respiratory rate, and blood oxygen saturation were observed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN), and creatinine (Cr) levels were tested. General dose of ketamine, the time of onset and duration of anesthesia and postoperative recovery, anesthesia effect, and adverse reaction were subsequently compared. High-performance liquid chromatography was employed to detect ketamine concentration at different time points after administration, and the postoperative cognition function was further evaluated.
Results: Intra- and post-operation, the rising degree of ALT, AST, BUN, and Cr in patients treated with ketamine was higher than those in patients treated with the ketamine-lidocaine complex. General dose of ketamine, the time of onset and duration of anesthesia, postoperative recovery time, and the incidence rate of adverse reaction in patients treated with ketamine-lidocaine complex were lower, but the concentration of ketamine was higher compared to the patients treated with ketamine. In patients treated with the ketamine-lidocaine complex, elimination half-life of ketamine was prolonged, the area under curve was increased, and the plasma clearance rate was decreased relative to those with ketamine alone.
Conclusions: Ketamine combined with lidocaine may be beneficial in shortening the onset of anesthesia, promoting postoperative awake, prolonging elimination half-life, increasing area under curve, and decreasing plasma clearance rate and incidence of adverse reactions.
(© 2019 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals, Inc.)
Databáze: MEDLINE
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