Evaluation of Low-Dose Ketamine on Inflammatory Biomarker Profile Following Off-Pump Coronary Artery Bypass Grafting

Abstract

The role of ketamine in attenuating the postoperative inflammatory response is a subject of recent clinical interest. Despite several studies elucidating the anti-inflammatory potential of ketamine in on-pump coronary artery bypass grafting and noncardiac surgeries, the literature on the role of ketamine in ameliorating systemic inflammatory response syndrome following off-pump coronary artery bypass grafting (OPCAB) is rather scarce. This prospective observational study was designed to compare the postoperative inflammatory milieu with and without the addition of low dose (0.5 mg/kg) of ketamine to the anesthetic regimen in the patients undergoing OPCAB, wherein 60 patients were allocated to group T, receiving ketamine (n = 30) and the group C, not receiving ketamine (n = 30). The estimated biomarkers included C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), troponin T, and creatine kinase-MB (CK-MB) at the following time points: prior to induction (T0), immediate postoperative period (T1), 4 hours postoperatively (T2), 24 hours postoperatively (T3), and 48 hours postoperatively (T4). The major finding of the study was a significant reduction in the postoperative values of CRP and IL-6 at T1, T2, T3, and T4 (p < 0.001) However, postoperative serum levels of TNF-α, CK-MB, and troponin T were comparable in the group T and group C. The average postoperative CRP and IL-6 levels positively correlated with the VISh (the highest postoperative vasopressor inotrope score) with the r values of 0.733 (p < 0.001) and 0.704 (p < 0.001), respectively. The index study substantiates the anti-inflammatory potential of ketamine in preventing immune function alterations attributable to anesthesia and cardiac surgery.

Keywords

inflammatory markers - Ketamine - OPCAB

Publication History

Article published online:
01 July 2020

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