Evaluation of the Neuroprotective Effects of S(+)-Ketamine During Open-Heart Surgery
2004; Lippincott Williams & Wilkins; Linguagem: Inglês
10.1213/01.ane.0000117227.00820.0c
ISSN1526-7598
AutoresW. Nagels, R. Demeyere, Jan Van Hemelrijck, E. Vandenbussche, K. Gijbels, E. Vandermeersch,
Tópico(s)Cardiac, Anesthesia and Surgical Outcomes
ResumoIn Brief We compared the effect of S(+)-ketamine to remifentanil, both in combination with propofol, on the neurocognitive outcome after open-heart surgery in 106 patients. A battery of neurocognitive tests was administered before surgery and 1 and 10 wk after surgery. Fourteen patients (25%) in the control group and 10 patients (20%) in the S(+)-ketamine group had 2 or more tests with a cognitive deficit (decline by at least one preoperative SD of that test in all patients) 10 wk after surgery (P = 0.54). Z-scores were calculated for all tests. No significantly better performance could be detected in the S(+)-ketamine group, except for the Trailmaking B test 10 wk after surgery. We conclude that S(+)-ketamine offers no greater neuroprotection compared with remifentanil during open-heart surgery. IMPLICATIONS:N-methyl-D-aspartic acid receptors play an important role during ischemic brain injury. We could not demonstrate that S(+)-ketamine resulted in greater neuroprotective effects compared with remifentanil during cardiopulmonary bypass procedures when both were combined with propofol.
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