JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (13) Citing Articles via Google Scholar Google Scholar Articles by Zilberstein, G. Articles by Roytblat, L. Search for Related Content PubMed PubMed Citation Articles by Zilberstein, G. Articles by Roytblat, L. Related Collections Cardiovascular Heart Pharmacology

---

CARDIOVASCULAR ANESTHESIA

Ketamine Attenuates Neutrophil Activation After Cardiopulmonary Bypass

Genadi Zilberstein, MD^*, Rachel Levy, PhD, Maxim Rachinsky, MD^*, Allan Fisher, MD^*, Lev Greemberg, MD^*, Yoram Shapira, MD PhD^*, Azai Appelbaum, MD, and Leonid Roytblat, MD^*

*Division of Anesthesiology, Laboratory of Infectious Diseases, and Departments of Clinical Biochemistry and Cardiothoracic Surgery, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Address correspondence and reprint requests to Leonid Roytblat, MD, Division of Anesthesiology, Soroka Medical Center, PO Box 151, Beer-Sheva 84101, Israel. Address e-mail to l.roytblat{at}iname.com

Surgery is associated with activation of neutrophils and their influx into affected tissue. The pathogenic role of superoxide production generated by activated neutrophils has been documented repeatedly. Ketamine suppresses neutrophil oxygen radical production in vitro. In the present study, we compared the effect of adding small-dose ketamine to opioids during the induction of general anesthesia on superoxide production by neutrophils after coronary artery bypass grafting (CABG). Thirty-five patients undergoing elective CABG were randomized to one of two groups and prospectively studied in a double-blinded manner. The patients received either ketamine 0.25 mg/kg or a similar volume of saline in addition to large-dose fentanyl anesthesia. Blood samples were drawn before the operation, immediately after cardiopulmonary bypass, 24 and 48 postoperative h, and on postoperative Days 3–6. Functional capacity of neutrophils was assessed by superoxide generation after stimulation with phorbol 12-myristate 13-acetate, opsonized zymosan, or formyl-methionyl-leucyl-phenylalanine. The addition of small-dose ketamine to general anesthesia attenuates increased production of the superoxide anion (O2-) by neutrophils without chemical stimulation and after stimulation with phorbol 12-myristate 13-acetate, formyl-methionyl-leucyl-phenylalanine, and opsonized zymosan for 4–6 days after CABG. In addition, ketamine attenuated the percentage of neutrophils on postoperative Days 2–6. In the Control group, superoxide production significantly increased compared with the baseline value. By contrast, in the Ketamine group, this difference was not significant.

IMPLICATIONS: In a randomized, double-blinded, prospective clinical study, we compared the effect of adding small-dose ketamine to opioids during general anesthesia on superoxide production and showed that ketamine suppressed the increase of superoxide anion production by neutrophils after coronary artery bypass grafting.

This article has been cited by other articles:

				J. G. Bovill Anesthetic Pharmacology: Reflections of a Section Editor Anesth. Analg., November 1, 2007; 105(5): 1186 - 1190. [Full Text] [PDF]

				B. Beilin, Y. Rusabrov, Y. Shapira, L. Roytblat, L. Greemberg, I. Z. Yardeni, and H. Bessler Low-dose ketamine affects immune responses in humans during the early postoperative period Br. J. Anaesth., October 1, 2007; 99(4): 522 - 527. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999