Hemodynamic Effects Ketamine versus Ketamine with Thiopental for Patients Undergoing Abdominal Surgery

Assefa, Andibirku Andualem; Zema, Kanche Zewde; Wondimeneh, Demissie Birhanu; Demeke, G/Medihin Tsegaye; Debalke, Gemechu Ashebir; Eshetu, Haile Kirubel

doi:10.23937/2377-4630/1410139

Cited by 1 publication

(2 citation statements)

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“…The findings of our study regarding the ketamine effect were supported by Demir et al (2018) in Turkey, who proved the effectiveness of a sub-anesthetic dose of ketamine in reducing HR, blood pressure, pain, and EA [ 38 ]. Also consistent with our results, Andibirku et al (2022) in Ethiopia reported a significant rise followed by a decrease in HR after 10 minutes in the ketamine group, which did not occur in the comparative group who received thiopental in addition to ketamine [ 39 ].…”

Section: Discussionsupporting

confidence: 92%

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Effect of three modalities on emergence agitation among post-traumatic stress disorder patients undergoing laparoscopy: a randomized controlled study

Abdelaziz,

Dean,

Elshafie

2024

BMC Psychiatry

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Background and aim Emergence agitation (EA) after general anesthesia is common in patients with post-traumatic stress disorder (PTSD). Due to the recent worldwide events such as the Covid-19 pandemic and wars, PTSD is not rare. Accordingly, a reliable, cost-effective anesthetic protocol to lower the incidence of EA is crucial. Therefore, we aimed to compare three different interventions for avoiding EA in PTSD patients undergoing gynecological laparoscopic surgery. Participants were divided into four groups: 1: performing pre-operative relaxation techniques (deep breathing exercise and progressive muscle relaxation [PMR]); 2: administrating intra-operative Ketamine; 3: applying both previously mentioned strategies and 4 as controls. Methods This study was carried out on 144 adult women scheduled for gynecological laparoscopy, randomly allocated into four groups: three intervention groups and a control group (36 each). Women aged 18-45 years old, with a diagnosis of PTSD were included in the study. Patients with a positive history of major neurological, cardiovascular, metabolic, respiratory, or renal disease were excluded. Any patient who reported the use of psychiatric drugs were also excluded from the study. Data was analyzed using IBM SPSS Statistics software version 26. Kolmogorov- Smirnov was used to verify the normality of the distribution of variables. Odds ratio was calculated to clarify the strength and direction of the association between intervention groups and control. Data was deemed significant at a p-value ≤0.05. Results Heart rate (HR) and Mean Arterial Blood Pressure (MABP) intra-operative and post-operative till 24 hours were significantly lower in groups 1, 2, and 3 compared to group 4 (p<0.001). There was a significant statistical difference in the intraoperative HR percentage decrease. MABP percentage decrease post-operative was higher in all the intervention groups with no statistically significant difference, except for group 1 compared to group 4, which was statistically significant (12.28 ± 11.77 and 6.10 ± 7.24, p=0.025). Visual Analogue Scale measurements were significantly less in the intervention groups 1, 2, and 3 compared to group 4. On Riker sedation–agitation scores, group 1 was 85 times more likely to be non-agitated (85 (15.938 – 453.307), p<0.001), group 2 was 175 times more likely to be non-agitated (175 (19.932–1536.448), p<0.001) and group 3 was protected against agitation. Conclusion Pre-operative relaxation techniques (breathing exercises and PMR) significantly lowered HR, MABP, VAS score, and EA than controls. These effects were not significantly different from intra-operative ketamine injection or the combination of both (relaxation techniques and ketamine). We recommend routine pre-operative screening for PTSD and the application of relaxation techniques (breathing exercises and PMR) in the pre-operative preparation protocol of PTSD-positive cases as well as routine practical application of preoperative relaxation techniques. Further studies on using pre-operative relaxation techniques in general could be cost-effective.

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Section: Discussionsupporting

confidence: 92%

“…(2022) in Ethiopia reported a significant rise followed by a decrease in HR after 10 minutes in the ketamine group, which did not occur in the comparative group who received thiopental in addition to ketamine [39].…”

Section: Discussionmentioning

confidence: 91%