Indian Journal of Anaesthesia  
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ORIGINAL ARTICLE
Year : 2017  |  Volume : 61  |  Issue : 7  |  Page : 549-555

Effect of ketamine on pro- and anti-inflammatory cytokine response in paediatric cardiac surgery: A prospective randomised controlled study


1 Department of Anaesthesiology, King Faisal Specialist Hospital and Research Centre (Jeddah Branch), Jeddah, Saudi Arabia; Department of Anaesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo
2 Department of Anaesthesiology, King Faisal Specialist Hospital and Research Centre (Jeddah Branch), Jeddah, Saudi Arabia
3 Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Centre (Jeddah Branch), Jeddah, Saudi Arabia; Department of Cardiothoracic Surgery, Mansoura University, Mansoura, Egypt
4 Department of Pathology and Laboratory Medicine, King Faisal Specialist Hospital and Research Centre (Jeddah Branch), Jeddah, Saudi Arabia

Correspondence Address:
Tamer Hamed Ibrahim
King Faisal Specialist Hospital and Research Center, Alrawda District, P.O. Box: 40047, MBC-J22, Jeddah 21499

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ija.IJA_607_16

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Background and Aims: Paediatric cardiac surgery with cardiopulmonary bypass (CPB) is associated with a marked inflammatory response and triggers release of inflammatory cytokines. The aim of this study was to study the effect of ketamine on the inflammatory response during correction of congenital cyanotic heart diseases. Methods: Sixty-six patients with congenital cyanotic heart diseases scheduled for cardiac surgery were randomised into three groups. Group A patients did not receive ketamine (control group), Group B patients received 2 mg/kg ketamine intravenous (IV) and Group C patients received ketamine 2 mg/kg IV and an IV infusion of ketamine (50 μg/kg/min). Interleukin (IL) levels for IL-6, IL-8, IL-10, C-reactive protein (CRP) and tumour necrosis factor-α (TNF-α) levels were examined in the three groups at four timings: pre-operative (baseline), intraoperative (after weaning off the CPB) and post-operative (6 and 24 h after weaning off CPB). Paired sample t-test and ANOVA test were used for statistical analysis and P< 0.05 was considered statistically significant. Results: Within each group, the intra- and post-operative serum levels of IL-6, IL-8, IL-10 and CRP were significantly elevated from the baseline, however, TNF-α was not significantly elevated. There were no statistically significant differences in the IL, CRP or TNF-α levels between the three groups. Conclusion: Paediatric cardiac surgery for congenital cyanotic heart disease is a triggering factor for the inflammatory response, yet we could not detect any beneficial effect of ketamine on that response whether given either as an IV induction dose or continued as an IV infusion.


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