Résumé
BACKGROUND: The aims of the study were to evaluate hemodynamic and stress hormone responses during abdominal hysterectomy under enflurane anesthesia supplemented by continuous ketamine infusion. METHODS: Eighteen patients scheduled for elective abdominal hysterectomy under enflurane anesthesia were randomly assigned to two groups, which received intravenous ketamine (0.3 mg/kg initially, followed by a continuous infusion at a rate of 0.15 mg/kg/h) (ketamine group, n = 9) or normal saline (control group, n = 9) 2 min after intubation. Hemodynamic responses, serum cortisol, prolactin, growth hormone, insulin and glucose concentrations were measured before induction, 2 min after intubation, 2 min after incision, at peritoneum closure, and 5 min after extubation. RESULTS: No significant differences were observed between the two groups in terms of hemodynamic responses, serum cortisol, prolactin, growth hormone, insulin and glucose concentrations. Compared with values before induction, significant increases in serum cortisol, prolactin, and glucose concentrations were observed at peritoneum closure and 5 min after extubation in both groups. However, growth hormone levels in the control group, and insulin concentration in both groups were significantly reduced 2 min after skin incision (P < 0.05). CONCLUSIONS: Bolus ketamine 0.3 mg/kg IV followed by a 0.15 mg/kg/h infusion fails to suppress stress responses, such as increases in serum cortisol, prolactin, growth hormone, and glucose concentrations, or insulin reduction at surgery under enflurane anesthesia.