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J Cardiothorac Vasc Anesth. 2009 Oct;23(5):651-7. doi: 10.1053/j.jvca.2008.12.021. Epub 2009 Feb 23.

Ketamine attenuates delirium after cardiac surgery with cardiopulmonary bypass.

Author information

1
Department of Anesthesiology, Medical College of Wisconsin and Clement J. Zablocki Veterans Administration Medical Center, Milwaukee, WI, USA. judith.hudetz@va.gov

Abstract

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.

PMID:
19231245
DOI:
10.1053/j.jvca.2008.12.021
[Indexed for MEDLINE]

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