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Effect of low-dose ketamine on inflammatory response in off-pump coronary artery bypass graft surgery

 J. E. Cho  ;  J. K. Shim  ;  Y. S. Choi  ;  D. H. Kim  ;  S. W. Hong  ;  Y. L. Kwak 
 BRITISH JOURNAL OF ANAESTHESIA, Vol.102(1) : 23-28, 2009 
Journal Title
Issue Date
Aged ; Anesthetics, Dissociative/therapeutic use* ; Coronary Artery Bypass, Off-Pump/adverse effects* ; Female ; Humans ; Inflammation Mediators/blood* ; Interleukin-6/blood ; Ketamine/therapeutic use* ; Male ; Middle Aged ; Prospective Studies ; Systemic Inflammatory Response Syndrome/blood ; Systemic Inflammatory Response Syndrome/etiology ; Systemic Inflammatory Response Syndrome/prevention & control* ; Tumor Necrosis Factor-alpha/blood
anaesthetics i.v. ; ketamine ; heart ; coronary artery bypass
BACKGROUND: Off-pump coronary artery bypass graft surgery (OPCAB) is still associated with a marked systemic inflammatory response. The aim of this study was to investigate whether pre-emptive, low dose of ketamine, which has been reported to have anti-inflammatory activity in on-pump coronary artery bypass surgery, could reduce inflammatory response in low-risk patients undergoing OPCAB. METHODS: In this prospective randomized-controlled trial, 50 patients with stable angina and preserved myocardial function undergoing OPCAB were randomly assigned to receive either 0.5 mg kg(-1) of ketamine (Ketamine group, n=25) or normal saline (Control group, n=25) during induction of anaesthesia. Inflammatory markers including C-reactive protein (CRP), interleukin (IL)-6, tumour necrosis factor-alpha (TNF-alpha), and cardiac enzymes were measured previous to induction (T1), 4 h after surgery (T2), and the first and second days after the surgery (T3 and T4). RESULTS: There were no significant intergroup differences in the serum concentrations of the CRP, IL-6, and TNF-alpha and cardiac enzymes. Pro-inflammatory markers and cardiac enzymes, except TNF-alpha, were all increased after the surgery compared with baseline values in both groups. CONCLUSIONS: Low-dose ketamine administered during anaesthesia induction did not exert any evident anti-inflammatory effect in terms of reducing the serum concentrations of pro-inflammatory markers in low-risk patients undergoing OPCAB.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
Cho, Jang Eun(조장은)
Choi, Yong Seon(최용선) ORCID logo https://orcid.org/0000-0002-5348-864X
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