• Anesthesia and analgesia · Jun 2004

    Randomized Controlled Trial Comparative Study Clinical Trial

    Evaluation of the neuroprotective effects of S(+)-ketamine during open-heart surgery.

    • W Nagels, R Demeyere, J Van Hemelrijck, E Vandenbussche, K Gijbels, and E Vandermeersch.
    • Department of Anesthesiology, University Hospital Gasthuisberg, Katholieke Universiteit Leuven, Belgium. werner.nagels@skynet.be
    • Anesth. Analg. 2004 Jun 1; 98 (6): 1595-603, table of contents.

    UnlabelledWe compared the effect of S(+)-ketamine to remifentanil, both in combination with propofol, on the neurocognitive outcome after open-heart surgery in 106 patients. A battery of neurocognitive tests was administered before surgery and 1 and 10 wk after surgery. Fourteen patients (25%) in the control group and 10 patients (20%) in the S(+)-ketamine group had 2 or more tests with a cognitive deficit (decline by at least one preoperative SD of that test in all patients) 10 wk after surgery (P = 0.54). Z-scores were calculated for all tests. No significantly better performance could be detected in the S(+)-ketamine group, except for the Trailmaking B test 10 wk after surgery. We conclude that S(+)-ketamine offers no greater neuroprotection compared with remifentanil during open-heart surgery.ImplicationsN-methyl-D-aspartic acid receptors play an important role during ischemic brain injury. We could not demonstrate that S(+)-ketamine resulted in greater neuroprotective effects compared with remifentanil during cardiopulmonary bypass procedures when both were combined with propofol.

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