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Excerpt
Introduction: The combination of ketamine and propofol has been described as a haemodynamically stable anaesthesia technique [1]. We investigated whether the more potent S(+)-ketamine can be used during heart valve surgery.
Method: Fourteen patients were enrolled and underwent heart valve surgery. Anaesthesia was provided by a target controlled infusion (TCI) of propofol, which could be altered between 1 and 4 μg mL−1. A bolus of 2.5 mg kg−1 S(+)-ketamine was administered and a continuous infusion of 125 μg kg−1 min−1 was started. Cisatracurium 0.2 mg kg−1 was used as muscle relaxant. Five minutes after induction the patient was intubated. No opioids were used. Systolic (SAP), mean (MAP), diastolic (DAP) arterial pressures and heart rate (HR) were recorded. If the mean arterial pressure was less than 60 mmHg phenylephrine or ephedrine was given. ANOVA for repeated measurements and Scheffé's F-test were used.
Results: The results are presented in Figure 1. Phenylephrine and ephedrine were administered in 8 patients with a mean dose of 100 μg and 2.5 mg respectively.
Discussion: S(+)-ketamine with propofol can be a suitable technique during heart valve surgery, although the intubation response is not completely blunted. A short-acting opioid might be needed.
