• Mahmoud Abdelfattah, Ibrahim Abdelbaser, Karim Ali Awad, Ahmed Magdy Atallah, Mohamed Sanad, and Mohamed Sayedalahl.
• Department of Anesthesia and Surgical Intensive Care, Faculty of Medicine, Mansoura University, Mansoura, Egypt. Electronic address: Drmahmoudhassan@mans.edu.eg.
• J. Cardiothorac. Vasc. Anesth. 2024 Oct 1; 38 (10): 234923552349-2355.

ObjectiveThis study was designed to evaluate the effect of low-dose ketamine infusion on the perioperative consumption of opioids in pediatric open cardiac surgery.DesignA randomized, controlled, double-blinded single-center study was conducted.SettingThe study took place in a tertiary care children's hospital.ParticipantsPatients of both sexes aged 2-12 years who underwent cardiac surgery were included.InterventionsPatients in the ketamine group received a bolus of 0.3 mg/kg of ketamine before skin incision followed by continuous intraoperative infusion of 0.25 mg/kg/h and postoperative infusion of 0.1 mg/kg/h for 24 h. Patients in the control groups received volumes of normal saline either bolus or continuous infusion like that of the ketamine group.Measurements And Main ResultsThe primary outcome was the total dose of fentanyl consumed over the first 24 hours postoperatively. Secondary outcomes were intraoperative fentanyl consumption, time to extubation, modified objective pain score, and incidence of vomiting, pruritus, diplopia, or hallucinations. A total of 80 patients were recruited but the final analysis was done on 35 patients in the ketamine group and 34 in the control group. Fentanyl consumption during surgery and in the first 24 hours postoperatively was significantly lower in the ketamine than the control group. Patients in both the ketamine and control groups had similar times to extubation. Modified objective pain scores were significantly lower in the ketamine group than the control group. None of the patients in either group had diplopia or hallucinations.ConclusionsLow-dose ketamine infusion in children undergoing open cardiac surgery reduced intra- and postoperative opioid consumption and postoperative pain scores. Moreover, ketamine did not cause diplopia or hallucinations.Copyright © 2024 Elsevier Inc. All rights reserved.

26 keywords...

hide…