Effect of Continuous Infusion of Ketamine on the Cortisol and Hyperglycemic Response to Abdominal Surgery during General Anesthesia / 대한마취과학회지

ABSTRACT

BACKGROUND: The effect of a continuous infusion of ketamine on the cortisol and hyperglycemic response induced by surgery was studied in patients undergoing an abdominal hysterectomy under enflurane anesthesia. METHODS: Twenty adult female patients were randomly allocated to two groups receiving intravenous ketamine (0.3 mg/kg initially, followed by a continuous infusion at a rate of 0.15 mg/kg/h) (ketamine group, n = 10) or normal saline (control group, n = 10) 2 min after intubation. Hemodynamic responses, serum cortisol and glucose concentrations were measured before induction, 2 min after intubation, 2 min after incision, at closure of peritoneum and 5 min after extubation. Inspired and expired concentrations of enflurane were also evaluated. RESULTS: There were no significant differences in hemodynamic responses, inspired and expired concentrations of enflurane, serum cortisol and glucose concentrations between the two groups. As compared with the values before induction, significant increases were seen in serum cortisol (control 2.3-2.6 times, ketamine 2-2.2 times) and glucose concentrations (control 1.2-1.3 times, ketamine 1.3 times) at closure of peritoneum and 5 min after extubation in both groups (P<0.05). CONCLUSIONS: Continuous infusion of an analgesic dose of ketamine could not abolish the increases in serum cortisol and glucose induced by abdominal surgery under enflurane anesthesia.