Chen B Zhao1, Jianjian Yu2, Maiying Kong3, Jiange Han4, Hongyin Du5, Jiapeng Huang6. 1. Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY. 2. First Central Clinical College, Tianjin Medical University, Tianjin, China; Department of Anesthesiology, Tianjin Chest Hospital, Tianjin, PR China. 3. Department of Bioinformatics and Biostatistics, School of Public Health and Information Sciences, University of Louisville, Louisville. 4. Department of Anesthesiology, Tianjin Chest Hospital, Tianjin, PR China. 5. First Central Clinical College, Tianjin Medical University, Tianjin, China. 6. Department of Anesthesiology & Perioperative Medicine, University of Louisville, Louisville, KY; Division of Infectious Diseases, Center of Excellence for Research in Infectious Diseases (CERID), University of Louisville, Louisville, KY; Department of Cardiovascular & Thoracic Surgery, School of Medicine, University of Louisville, Louisville; Center for Integrative Environmental Health Sciences, University of Louisville, Louisville, KY; Department of Pharmacology & Toxicology, School of Medicine, University of Louisville, Louisville. Electronic address: jiapeng.huang@louisville.edu.
Abstract
PURPOSE: To study the feasibility and outcomes of ketamine as an anesthetic adjunct during monitored anesthesia care (MAC) in transcatheter aortic valve replacement (TAVR). DESIGN: This was a retrospective study. METHODS: Data from 155 consecutive TAVR patients at a tertiary care high-volume TAVR medical center were reviewed and analyzed. FINDINGS: Among the 155 TAVR cases under MAC, intravenous ketamine was administered as an adjunct in 126 patients. The most common ketamine dose was 20 mg. There was no significant difference for postoperative stroke, intraoperative conversion to general anesthesia, postoperative delirium, need for permanent pacemaker implantation, perivalvular leak and length of stay between the ketamine and non-ketamine groups. The ketamine group demonstrated a statistically significant lower 30-day mortality (P = .0381) and intraoperative cardiac arrest (P = .0025) rate when compared to the nonketamine group. CONCLUSIONS: Our results demonstrated that employing ketamine as an adjunct during MAC for TAVR is a feasible option.
PURPOSE: To study the feasibility and outcomes of ketamine as an anesthetic adjunct during monitored anesthesia care (MAC) in transcatheter aortic valve replacement (TAVR). DESIGN: This was a retrospective study. METHODS: Data from 155 consecutive TAVR patients at a tertiary care high-volume TAVR medical center were reviewed and analyzed. FINDINGS: Among the 155 TAVR cases under MAC, intravenous ketamine was administered as an adjunct in 126 patients. The most common ketamine dose was 20 mg. There was no significant difference for postoperative stroke, intraoperative conversion to general anesthesia, postoperative delirium, need for permanent pacemaker implantation, perivalvular leak and length of stay between the ketamine and non-ketamine groups. The ketamine group demonstrated a statistically significant lower 30-day mortality (P = .0381) and intraoperative cardiac arrest (P = .0025) rate when compared to the nonketamine group. CONCLUSIONS: Our results demonstrated that employing ketamine as an adjunct during MAC for TAVR is a feasible option.
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