Ketamine Attenuates the Interleukin-6 Response After Cardiopulmonary Bypass
| Autor: | Gabriel M. Gurman, Alexander Pekar, Yoram Shapira, Maxim Rachinsky, Azai Appelbaum, Leonid Roytblat, Lev Greemberg, Amos Duvdenani, Daniel Talmor |
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| Rok vydání: | 1998 |
| Předmět: |
Male
Anesthesia General law.invention Fentanyl Coronary artery bypass surgery Double-Blind Method law medicine Cardiopulmonary bypass Humans Ketamine Postoperative Period Prospective Studies Derivation Coronary Artery Bypass Aged Anesthetics Dissociative Cardiopulmonary Bypass Interleukin-6 business.industry Organ dysfunction Middle Aged medicine.disease Systemic inflammatory response syndrome Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Female medicine.symptom business Anesthetics Intravenous medicine.drug Artery |
| Zdroj: | Anesthesia & Analgesia. 87:266-271 |
| ISSN: | 0003-2999 |
| DOI: | 10.1097/00000539-199808000-00006 |
| Popis: | UNLABELLED Cardiopulmonary bypass (CPB) has been proposed as a model for studying the inflammatory cascade associated with the systemic inflammatory response syndrome. Serum interleukin-6 (IL-6) concentration seems to be a good indicator of activation of the inflammatory cascade and predictor of subsequent organ dysfunction and death. Prolonged increases of circulating IL-6 are associated with morbidity and mortality after cardiac operations. In the present study, we compared the effects of adding ketamine 0.25 mg/kg to general anesthesia on serum IL-6 levels during and after elective coronary artery bypass grafting (CABG). Thirty-one patients undergoing elective CABG were randomized to one of two groups and prospectively studied in a double-blind manner. The patients received either ketamine 0.25 mg/kg or a similar volume of isotonic sodium chloride solution in addition to large-dose fentanyl anesthesia. Blood samples for analysis of serum IL-6 levels were drawn before the operation; after CPB; 4, 24, and 48 h after surgery; and daily for 6 days beginning the third day postoperatively. Ketamine suppressed the serum IL-6 response immediately after CPB and 4, 24, and 48 h postoperatively (P < 0.05). During the first 7 days after surgery, the serum IL-6 levels in the ketamine group were significantly lower than those in the control group (P < 0.05). On Day 8 after surgery, IL-6 levels were no different from baseline values in both groups. A single dose of ketamine 0.25 mg/kg administered before CPB suppresses the increase of serum IL-6 during and after CABG. IMPLICATIONS In this randomized, double-blind, prospective study of patients during and after coronary artery bypass surgery, we examined whether small-dose ketamine added to general anesthesia before cardiopulmonary bypass suppresses the increase of the serum interleukin-6 (IL-6) concentration. Serum IL-6 levels correlate with the patient's clinical course during and after coronary artery bypass. Ketamine suppresses the increase of serum IL-6 during and after coronary artery bypass surgery. |
| Databáze: | OpenAIRE |
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