Ketamine attenuates delirium after cardiac surgery with cardiopulmonary bypass. J Cardiothorac Vasc Anesth 2009 Oct;23(5):651-7
Date
02/24/2009Pubmed ID
19231245DOI
10.1053/j.jvca.2008.12.021Scopus ID
2-s2.0-67651203271 (requires institutional sign-in at Scopus site) 205 CitationsAbstract
OBJECTIVE: To determine if ketamine attenuates postoperative delirium concomitant with an anti-inflammatory effect in patients undergoing cardiac surgery using cardiopulmonary bypass.
DESIGN: A prospective randomized study.
SETTING: A Veterans Affairs medical center.
PARTICIPANTS: Cardiac surgical patients.
INTERVENTIONS: Patients at least 55 years of age randomly received placebo (0.9% saline, n = 29) or an intravenous bolus of ketamine (0.5 mg/kg intravenously, n = 29) during anesthetic induction in the presence of fentanyl and etomidate.
MEASUREMENTS AND MAIN RESULTS: Delirium was assessed by using the Intensive Care Delirium Screening Checklist before and after surgery. Serum C-reactive protein concentrations were determined before and 1 day after surgery. The incidence of postoperative delirium was lower (p = 0.01, Fisher exact test) in patients receiving ketamine (3%) compared with placebo (31%). Postoperative C-reactive protein concentration was also lower (p < 0.05) in the ketamine-treated patients compared with the placebo-treated patients. The odds of developing postoperative delirium were greater for patients receiving placebo compared with ketamine treatment (odds ratio = 12.6; 95% confidence interval, 1.5-107.5; logistic regression).
CONCLUSIONS: After cardiac surgery using cardiopulmonary bypass, ketamine attenuates postoperative delirium concomitant with an anti-inflammatory effect.
Author List
Hudetz JA, Patterson KM, Iqbal Z, Gandhi SD, Byrne AJ, Hudetz AG, Warltier DC, Pagel PSAuthor
Sweeta D. Gandhi MD Associate Professor in the Anesthesiology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAged, 80 and over
Cardiac Surgical Procedures
Cardiopulmonary Bypass
Delirium
Humans
Inflammation Mediators
Ketamine
Male
Middle Aged
Postoperative Complications
Prospective Studies
Time Factors
