Mohammad Reza Habibi1, Afshin Gholipour Baradari1, Aria Soleimani2, Amir Emami Zeydi3, Hamid Sharif Nia4, Ali Habibi5, Naser Onagh5. 1. Faculty of Medicine, Department of Anesthesiology, Mazandaran University of Medical Sciences , Sari, Iran . 2. Faculty of Paramedicine, Department of Anesthesiology, Mazandaran University of Medical Sciences , Sari, Iran . 3. PhD Student in Nursing, Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences , Mashhad, Iran . 4. Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences , Sari, Iran . 5. Medical Student, Faculty of Medicine, Mazandaran University of Medical Sciences , Sari, Iran .
Abstract
BACKGROUND: During induction of anesthesia and intubation, hemodynamic changes are very important; especially in patients with coronary artery disease (CAD) and left ventricular dysfunction. A little information is available on the hemodynamic effects of a combination of ketamine-thiopental for induction of anesthesia in patients undergoing coronary artery bypass graft (CABG) surgery, with impaired ventricular function. AIM: The aim of this study was to compare the hemodynamic responses to etomidate versus ketamine-thiopental sodium combination for anesthetic induction in CABG surgery patients with low ejection fraction (EF<45%). MATERIALS AND METHODS: In a double blind randomized clinical trial, a total of 100 patients, scheduled for elective CABG surgery were randomly assigned into two groups. These patients received either etomidate or ketamine-thiopental sodium combination at induction of anesthesia. Hemodynamics variable were measured and recorded at baseline, immediately before and after laryngoscopy and intubation, one, two and three minutes after intubation. Also, muscle twitching incidence among patients in two groups was evaluated. RESULTS: No significant differences between the two groups regarding the changes of hemodynamic variables including systolic and diastolic arterial blood pressure, mean arterial pressure and heart rate, were notice (p>0.05). Muscle twitching was not observed in the two groups. CONCLUSION:Hemodynamic stability after administration of ketamine-thiopental sodium combination for induction of anesthesia in patients undergoing CABG surgery, with impaired ventricular function, supports the clinical impression that this combination is safe in CABG surgery patients with low EF.
RCT Entities:
BACKGROUND: During induction of anesthesia and intubation, hemodynamic changes are very important; especially in patients with coronary artery disease (CAD) and left ventricular dysfunction. A little information is available on the hemodynamic effects of a combination of ketamine-thiopental for induction of anesthesia in patients undergoing coronary artery bypass graft (CABG) surgery, with impaired ventricular function. AIM: The aim of this study was to compare the hemodynamic responses to etomidate versus ketamine-thiopental sodium combination for anesthetic induction in CABG surgery patients with low ejection fraction (EF<45%). MATERIALS AND METHODS: In a double blind randomized clinical trial, a total of 100 patients, scheduled for elective CABG surgery were randomly assigned into two groups. These patients received either etomidate or ketamine-thiopental sodium combination at induction of anesthesia. Hemodynamics variable were measured and recorded at baseline, immediately before and after laryngoscopy and intubation, one, two and three minutes after intubation. Also, muscle twitching incidence among patients in two groups was evaluated. RESULTS: No significant differences between the two groups regarding the changes of hemodynamic variables including systolic and diastolic arterial blood pressure, mean arterial pressure and heart rate, were notice (p>0.05). Muscle twitching was not observed in the two groups. CONCLUSION: Hemodynamic stability after administration of ketamine-thiopental sodium combination for induction of anesthesia in patients undergoing CABG surgery, with impaired ventricular function, supports the clinical impression that this combination is safe in CABG surgery patients with low EF.
Authors: J Morel; M Salard; C Castelain; M C Bayon; P Lambert; M Vola; C Auboyer; S Molliex Journal: Br J Anaesth Date: 2011-06-17 Impact factor: 9.166
Authors: José L Iribarren; Juan J Jiménez; Domingo Hernández; Lisset Lorenzo; Maitane Brouard; Antonio Milena; María L Mora; Rafael Martínez Journal: J Cardiothorac Surg Date: 2010-04-19 Impact factor: 1.637