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BJA Advance Access published online on November 20, 2008
British Journal of Anaesthesia, doi:10.1093/bja/aen325
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Effect of low-dose ketamine on inflammatory response in off-pump coronary artery bypass graft surgery

J. E. Cho1, J. K. Shim1,2, Y. S. Choi1, D. H. Kim1, S. W. Hong1 and Y. L. Kwak1,2,*

1 Department of Anaesthesiology and Pain Medicine
2 Anaesthesia and Pain Research Institute, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Ku, Seoul 120-752, Republic of Korea

* Corresponding author. E-mail: ylkwak{at}yuhs.ac

Background: Off-pump coronary artery bypass graft surgery (OPCAB) is still associated with a marked systemic inflammatory response. The aim of this study was to investigate whether pre-emptive, low dose of ketamine, which has been reported to have anti-inflammatory activity in on-pump coronary artery bypass surgery, could reduce inflammatory response in low-risk patients undergoing OPCAB.

Methods: In this prospective randomized-controlled trial, 50 patients with stable angina and preserved myocardial function undergoing OPCAB were randomly assigned to receive either 0.5 mg kg–1 of ketamine (Ketamine group, n=25) or normal saline (Control group, n=25) during induction of anaesthesia. Inflammatory markers including C-reactive protein (CRP), interleukin (IL)-6, tumour necrosis factor-{alpha} (TNF-{alpha}), and cardiac enzymes were measured previous to induction (T1), 4 h after surgery (T2), and the first and second days after the surgery (T3 and T4).

Results: There were no significant intergroup differences in the serum concentrations of the CRP, IL-6, and TNF-{alpha} and cardiac enzymes. Pro-inflammatory markers and cardiac enzymes, except TNF-{alpha}, were all increased after the surgery compared with baseline values in both groups.

Conclusions: Low-dose ketamine administered during anaesthesia induction did not exert any evident anti-inflammatory effect in terms of reducing the serum concentrations of pro-inflammatory markers in low-risk patients undergoing OPCAB.

Keywords: anaesthetics i.v., ketamine; heart, coronary artery bypass


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