Ketamine as a neuroprotective and anti-inflammatory agent in children undergoing surgery on cardiopulmonary bypass: A pilot randomized, double-blind, placebo-controlled trial
Pediatric Critical Care Medicine,  Clinical Article

Bhutta AT et al. – The authors did not find any evidence for neuroprotection or neurotoxicity in the pilot study. A large, adequately powered randomized control trial is needed to discern the central nervous system effect of ketamine on the developing brain. brain.

Methods
  • The authors randomized 24 infants, without chromosomal abnormalities, to receive ketamine (2mg/kg, n=13) or placebo (saline, n=11) before cardiopulmonary bypass for repair of ventricular septal defects.
  • Plasma markers of inflammation and central nervous system injury were compared at the end of surgery, and 6, 24, and 48hrs after surgery.
  • Magnetic resonance imaging and spectroscopy before cardiopulmonary bypass and at the time of hospital discharge were performed in a subset of cases and controls (n=5 in each group).
  • Cerebral hemodynamics were monitored postoperatively using near–infrared spectroscopy, and neurodevelopmental outcomes were assessed using Bayley Scales of Infant Development–II before and 2–3wks after surgery.

Results
  • Statistically significant differences were noted in preoperative inspired oxygen levels, intraoperative cooling and postoperative temperature, respiratory rate, platelet count, and bicarbonate levels.
  • The peak concentration of C–reactive protein was lower in cases compared to controls at 24hrs (p=.048) and 48hrs (p=.001).
  • No significant differences were noted in the expression of various cytokines, chemokines, S100, and neuron–specific enolase between the cases and controls.
  • Magnetic resonance imaging with spectroscopy studies showed that ketamine administration led to a significant decrease in choline and glutamate plus glutamine/creatine in frontal white matter.
  • No statistically significant differences occurred between pre– and postoperative Bayley Scales of Infant Development–II scores.

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Surgery

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Surgery Articles

1 A novel endoscopic weight loss therapy using gastric aspiration: results after 6 months Endoscopy, October 7, 2014    Clinical Article

2 Abdominoplasty and seroma - A prospective randomised study comparing scalpel and handheld electrocautery dissection Journal of Plastic, Reconstructive & Aesthetic Surgery, October 29, 2014    Clinical Article

3 Four-step medial thighplasty: refined and reproducible Plastic and Reconstructive Surgery, November 6, 2014    Clinical Article

4 Non-invasive fat reduction of the flanks using a new cryolipolysis applicator and overlapping, two-cycle treatments Lasers in Surgery and Medicine, November 24, 2014    Clinical Article

5 Elective resection versus observation after nonoperative management of complicated diverticulitis with abscess: A systematic review and meta-analysis Diseases of the Colon and Rectum, November 14, 2014    Evidence Based Medicine    Review Article

6 Laparoscopic revolution in bariatric surgery Full Text World Journal of Gastroenterology, November 10, 2014    Free full text    Clinical Article

7 Effect of vagotomy during Roux-en-Y gastric bypass surgery on weight loss outcomes Obesity Research & Clinical Practice, November 4, 2014    Clinical Article

8 Comparison of stricture rates using three different gastrojejunostomy anastomotic techniques in laparoscopic Roux-en-Y gastric bypass Surgical Endoscopy, November 5, 2014    Review Article

9 Colorectal stenting: An advanced approach to malignant colorectal obstruction Full Text World Journal of Gastroenterology, November 25, 2014    Free full text    Review Article

10 The effect of the endoscopic duodenal-jejunal bypass liner on obesity and type 2 diabetes mellitus, a multicenter randomized controlled trial Annals of Surgery, November 19, 2014    Clinical Article

11 Laparoscopic sleeve gastrectomy versus laparoscopic Roux-en-Y gastric bypass: A single center experience with 2 years follow-up Obesity Surgery, August 8, 2014    Clinical Article

12 Hartmanns procedure vs loop colostomy in the treatment of obstructive rectosigmoid cancer Full Text World Journal of Emergency Surgery, October 21, 2014    Free full text    Clinical Article

13 Comparative effectiveness of laparoscopic adjustable gastric banding vs laparoscopic gastric bypass JAMA Surgery, November 3, 2014    Clinical Article

14 Fenestrated endovascular aortic aneurysm repair (FEVAR) procedure implemented at Danbury Hospital Western Connecticut Health Network, November 12, 2014

15 Endoscopic sleeve gastroplasty for the treatment of obesity Endoscopy, November 17, 2014    Clinical Article

16 Chemicals found in everyday fruits could minimise organ damage after heart attack and stroke University of Cambridge News, November 14, 2014

17 Aesthetic refinements in body contouring in the massive weight loss patient: Part 2. Arms Plastic and Reconstructive Surgery, November 7, 2014    Clinical Article

18 Study finds gallbladder surgery can wait Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center News, October 6, 2014

19 Initial experience with endoscopic sleeve gastroplasty: technical success and reproducibility in the bariatric population Endoscopy, November 13, 2014    Clinical Article

20 Does volume of cardiac catheterizations correlate with better outcomes? The Children's Hospital of Philadelphia, November 19, 2014

Indexed Journals in Surgery: Surgery, Journal of the American College of Surgeons, Annals of Surgerymore