Document Detail


Comparison of S-(+)-ketamine- with sufentanil-based anaesthesia for elective coronary artery bypass graft surgery: effect on troponin T levels.
MedLine Citation:
PMID:  18440952     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: S-(+)-ketamine anaesthesia carries potential benefits for the cardiovascularly compromised patient. However, the use of S-(+)-ketamine in ischaemic coronary artery disease is controversial. In a prospective, randomized, clinical trial, we have investigated whether an S-(+)-ketamine-based anaesthetic protocol leads to increased cardiac troponin T levels (cTnT) after coronary artery bypass grafting (CABG). METHODS: Two hundred and nine patients undergoing elective CABG were randomized to receive either i.v. anaesthesia with sufentanil-midazolam-propofol (SMP; n=108) or S-(+)-ketamine-midazolam-propofol (KMP; n=101). Haemodynamic variables were maintained within the normal range. Invasive haemodynamic monitoring was performed using a pulmonary artery catheter. Plasma cTnT levels were sampled before induction and 1, 6, and 24 h after aortic unclamping. Cardiovascular adverse events, such as electrocardiographic signs of ischaemia, perioperative myocardial infarction, and death, were recorded. RESULTS: Patient characteristics, cardiac profile, intraoperative management, and the incidence of cardiovascular adverse events were comparable between the groups. Plasma cTnT levels increased after operation in both groups. cTnT levels were significantly lower in the KMP group 6 h after aortic unclamping compared with the SMP group (P=0.004), but did not differ 24 h after aortic unclamping [median (range): SMP 0.4 (0.01-3.9) vs KMP 0.4 (0.07-6.6) microg litre(-1), P=0.338]. CONCLUSIONS: S-(+)-ketamine does not accentuate postoperative cTNT rises in haemodynamically stable elective CABG patients.
Authors:
C Neuhäuser; V Preiss; M-K Feurer; M Müller; S Scholz; M Kwapisz; M Mogk; I D Welters
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2008-04-24
Journal Detail:
Title:  British journal of anaesthesia     Volume:  100     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-16     Completed Date:  2008-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  765-71     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, Intensive Care Medicine and Pain Treatment, University Hospital Giessen and Marburg GmbH, Campus Giessen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Anesthetics, Combined / pharmacology
Anesthetics, Intravenous / pharmacology*
Biological Markers / blood
Cardiopulmonary Bypass
Coronary Artery Bypass*
Female
Humans
Ketamine / pharmacology*
Male
Midazolam / pharmacology
Middle Aged
Postoperative Period
Propofol / pharmacology
Prospective Studies
Sufentanil / pharmacology*
Troponin T / blood*,  drug effects
Chemical
Reg. No./Substance:
0/Anesthetics, Combined; 0/Anesthetics, Intravenous; 0/Biological Markers; 0/Troponin T; 2078-54-8/Propofol; 56030-54-7/Sufentanil; 59467-70-8/Midazolam; 6740-88-1/Ketamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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