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Related Experiment Videos

Ketamine concentrations during cardiopulmonary bypass

R F McLean1, A J Baker, S E Walker

  • 1Department of Anaesthesia, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.

Canadian Journal of Anaesthesia = Journal Canadien D'Anesthesie
|June 1, 1996
PubMed
Summary

This study measured ketamine serum concentrations in patients undergoing cardiopulmonary bypass (CPB). The ketamine infusion regimen maintained anesthetic levels throughout surgery, suggesting potential neuroprotective benefits in humans.

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Area of Science:

  • Anesthesiology
  • Cardiovascular Surgery
  • Pharmacology

Background:

  • Cardiopulmonary bypass (CPB) is a complex procedure requiring careful anesthetic management.
  • Ketamine is an anesthetic agent with potential neuroprotective properties.
  • Understanding ketamine pharmacokinetics during CPB is crucial for optimizing its use.

Purpose of the Study:

  • To determine serum ketamine concentrations during a specific dosing schedule in patients undergoing CPB.
  • To evaluate if the ketamine regimen maintains anesthetic levels throughout the surgical procedure.
  • To assess the feasibility of using this regimen to investigate ketamine's neuroprotective effects in humans.

Main Methods:

  • Prospective case series involving six patients over 60 years old undergoing coronary artery bypass grafting.

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  • Ketamine administered as a bolus (2 mg/kg) followed by continuous infusion (50 µg/kg/min) until 2 hours post-bypass.
  • Serum ketamine levels measured at multiple time points: pre-CPB, during CPB, and post-infusion.

    • Main Results:

    • Ketamine concentrations at aortic cannulation were approximately 3.11 µg/mL, decreasing by one-third upon CPB initiation.
    • Concentrations returned to pre-CPB levels by the end of bypass.
    • Post-infusion, ketamine levels declined log-linearly with an average half-life of 2.12 hours.

    Conclusions:

    • The studied ketamine dosage regimen effectively maintained general anesthetic concentrations during CPB.
    • Achieved ketamine levels are expected to exceed those shown to be neuroprotective in animal studies.
    • This regimen is suitable for further clinical trials assessing ketamine's neuroprotective potential in humans undergoing CPB.