Effective Use of Ketamine-Dexmedetomidine Following Propofol-Induced Hyperlactatemia: A Case Report

There are limited options for intravenous anesthetics and a lack of available information on the use of ketamine infusion during intracranial surgeries. We present a patient case report of hyperlactatemia during a craniotomy with neuromonitoring while on a propofol infusion with arterial lactate rising from 2.1 mmol/L to a peak of 5.0 mmol/L before reducing to 3.9 mmol/L after the transition to a mixed ketamine and dexmedetomidine infusion in order to maintain neuromonitoring quality and an appropriate depth of anesthesia. No complications were caused by the use of ketamine during this extended neurosurgery case.