| Comparison of S-(+)-ketamine- with sufentanil-based anaesthesia for elective coronary artery bypass graft surgery: effect on troponin T levels. | |
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MedLine Citation:
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PMID: 18440952 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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C Neuhäuser; V Preiss; M-K Feurer; M Müller; S Scholz; M Kwapisz; M Mogk; I D Welters |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2008-04-24 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 100 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-16 Completed Date: 2008-06-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 765-71 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, Intensive Care Medicine and Pain Treatment, University Hospital Giessen and Marburg GmbH, Campus Giessen, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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