Bartoc Cristian, Frumento Robert J, Jalbout Maya, Bennett-Guerrero Elliott, Du Evelyn, Nishanian Ervant
Department of Anesthesiology, Columbia University College of Physicians and Surgeons, New York, NY 10032-3784, USA.
J Cardiothorac Vasc Anesth. 2006 Apr;20(2):217-22. doi: 10.1053/j.jvca.2005.12.005. Epub 2006 Mar 9.
To determine whether ketamine administration affects markers of inflammation in cardiac surgery with cardiopulmonary bypass (CPB) and to investigate differences between 2 low-dose ketamine regimens.
Prospective, randomized, placebo-controlled trial.
Single-center university hospital.
Patients undergoing cardiac surgery with CPB.
Patients (n = 50) were randomized to 1 of 3 groups: ketamine, 0.25 mg/kg (n = 15); ketamine, 0.5 mg/kg (n = 18);or placebo (n = 17) in a double-blind manner at the time of induction of general anesthesia.
Serum C-reactive protein (CRP) and interleukin (IL)-6, IL-8, and IL-10 were measured at baseline, on intensive care unit (ICU) arrival, and on the first postoperative day (POD 1). Both ketamine doses decreased the serum IL-6 response at ICU arrival and POD 1 compared with placebo (p < 0.05). CRP was lower in the 0.5-mg/kg group than placebo on POD 1 (p = 0.003). IL-10 was lower in the ketamine groups (p = 0.01) at POD 1 compared with placebo; IL-8 levels were not affected by ketamine. Mean arterial pressure and systemic vascular resistance were higher at the end of surgery, arrival in the ICU, and POD 1 in the ketamine groups (p < 0.05).
Low-dose ketamine (0.5 mg/kg) attenuates increases in CRP, IL-6, and IL-10 while decreasing vasodilatation after CPB.
确定氯胺酮给药是否会影响体外循环（CPB）心脏手术中的炎症标志物，并研究两种低剂量氯胺酮给药方案之间的差异。
前瞻性、随机、安慰剂对照试验。
单中心大学医院。
接受CPB心脏手术的患者。
患者（n = 50）在全身麻醉诱导时以双盲方式随机分为3组中的1组：氯胺酮，0.25 mg/kg（n = 15）；氯胺酮，0.5 mg/kg（n = 18）；或安慰剂（n = 17）。
在基线、重症监护病房（ICU）入院时和术后第1天（POD 1）测量血清C反应蛋白（CRP）、白细胞介素（IL）-6、IL-8和IL-10。与安慰剂相比，两种氯胺酮剂量均降低了ICU入院时和POD 1时的血清IL-6反应（p < 0.05）。在POD 1时，0.5 mg/kg组的CRP低于安慰剂（p = 0.003）。与安慰剂相比，氯胺酮组在POD 1时的IL-10较低（p = 0.01）；氯胺酮对IL-8水平无影响。氯胺酮组在手术结束时、入住ICU时和POD 1时的平均动脉压和全身血管阻力较高（p < 0.05）。
低剂量氯胺酮（0.5 mg/kg）可减轻CPB后CRP、IL-6和IL-10的升高，同时减少血管扩张。
