A randomized, double-blind, placebo-controlled study assessing the anti-inflammatory effects of ketamine in cardiac surgical patients.
OBJECTIVE
To determine whether ketamine administration affects markers of inflammation in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate differences between 2 low-dose ketamine regimens.


METHODS
Prospective, randomized, placebo-controlled trial.


METHODS
Single-center university hospital.


METHODS
Patients undergoing cardiac surgery with CPB.


METHODS
Patients (n = 50) were randomized to 1 of 3 groups: ketamine, 0.25 mg/kg (n = 15); ketamine, 0.5 mg/kg (n = 18);or placebo (n = 17) in a double-blind manner at the time of induction of general anesthesia.


RESULTS
Serum C-reactive protein (CRP) and interleukin (IL)-6, IL-8, and IL-10 were measured at baseline, on intensive care unit (ICU) arrival, and on the first postoperative day (POD 1). Both ketamine doses decreased the serum IL-6 response at ICU arrival and POD 1 compared with placebo (p < 0.05). CRP was lower in the 0.5-mg/kg group than placebo on POD 1 (p = 0.003). IL-10 was lower in the ketamine groups (p = 0.01) at POD 1 compared with placebo; IL-8 levels were not affected by ketamine. Mean arterial pressure and systemic vascular resistance were higher at the end of surgery, arrival in the ICU, and POD 1 in the ketamine groups (p < 0.05).


CONCLUSIONS
Low-dose ketamine (0.5 mg/kg) attenuates increases in CRP, IL-6, and IL-10 while decreasing vasodilatation after CPB.
Bartoc
Cristian
C
Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY 10032-3784, USA.
Frumento
Robert J
RJ
Jalbout
Maya
M
Bennett-Guerrero
Elliott
E
Du
Evelyn
E
Nishanian
Ervant
E
D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002315:Cardiopulmonary Bypass; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000517:prevention & control*; D016753:Interleukin-10 / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007649:Ketamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D011183:Postoperative Complications; D011379:Prognosis; D011446:Prospective Studies; D014664:Vasodilation / Q000187:drug effects
D015415:Biomarkers; D018691:Excitatory Amino Acid Antagonists; D015850:Interleukin-6; D016209:Interleukin-8; D016753:Interleukin-10; D007649:Ketamine; D002097:C-Reactive Protein