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Related Experiment Videos

Continuous ketamine infusion for one-lung anaesthesia

A I Weinreich, G Silvay, P D Lumb

    Canadian Anaesthetists' Society Journal
    |September 1, 1980
    PubMed
    Summary

    Ketamine infusion effectively maintains oxygenation during one-lung anesthesia, preserving hypoxic pulmonary vasoconstriction. This intravenous anesthetic is a viable alternative to volatile agents for lung surgery patients.

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    Area of Science:

    • Anesthesiology
    • Pulmonary Medicine
    • Cardiovascular Physiology

    Background:

    • Hypoxic pulmonary vasoconstriction (HPV) normally optimizes blood flow to ventilated lung areas.
    • Volatile anesthetics can impair HPV, potentially worsening blood-gas exchange during lung surgery.
    • Intravenous anesthetics, unlike volatile agents, do not abolish the HPV reflex.

    Purpose of the Study:

    • To evaluate the efficacy of continuous ketamine infusion during one-lung anesthesia.
    • To assess ketamine's effect on oxygenation (PaO2) and shunt fraction in patients undergoing pulmonary resection.
    • To determine if ketamine preserves HPV, unlike volatile anesthetics.

    Main Methods:

    • A study involving 110 patients undergoing elective pulmonary resection.
    • Continuous infusion of ketamine for one-lung anesthesia.
    • Monitoring of PaO2 and shunt fraction at varying inspired oxygen fractions (FIO2 0.5 and 1.0).

    Main Results:

    • Ketamine infusion maintained PaO2 above 9.31 kPa (70 torr) with FIO2 1.0.
    • Shunt fraction increased from 25.9% (FIO2 0.5) to 36.0% (FIO2 1.0), indicating preserved HPV.
    • Ketamine provided analgesia and hypnosis, allowing high oxygen concentrations without recall concerns.

    Conclusions:

    • Continuous ketamine infusion is a satisfactory alternative to volatile agents for one-lung anesthesia.
    • Ketamine preserves HPV, which is crucial for managing oxygenation in patients undergoing lung surgery.
    • This approach is beneficial for patients where relative hypoxemia is unacceptable during surgery.

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