The Effect of Ketamine on the Hemodynamic status and Postoperative Pain in Addict Patients Undergoing Cardiac Surgery: A Double-Blind Clinical Trial

Abstract

Aim and Background: Pain is the most common and unpleasant symptom of diseases, which causes hemodynamic changes if left untreated. Considering the importance of pain, we decided to determine the effect of ketamine infusion on the post-operative pain and hemodynamic status in addict patients undergoing cardiac surgery. Materials and Methods: In this clinical trial which was performed in Baqiyatallah Hospital in 2020, 72 patients who were candidates for open heart surgery by using cardiopulmonary pump were randomly assigned to two groups. One group received ketamine and the other one received normal saline. Hemodynamic parameters including heart rate, systolic and diastolic pressures were measured before, during and after surgery. We also assessed postoperative pain by visual analogue scale (VAS). Using two sample t-test and repeated measures analysis of variance, we compared the groups with each other in regard to the hemodynamic parameters. Results: The results showed a significant difference in the intensity of postoperative pain between the control and ketamine groups, which was lower in the ketamine group (P = 0.001). Systolic and diastolic blood pressures were more stable in the ketamine group but the heart rate was higher at most times in ketamine group (P = 0.001). Conclusion: Continuous infusion of ketamine during heart surgery until 48 hours after surgery seems to reduce postoperative pain significantly and results in decreased use of narcotic drugs after surgery. It also stabilizes and improves hemodynamics and minimizes changes in hemodynamic status.

Keywords

• ketamine
• pain
• hemodynamic changes
• cardiac surgery
• addiction