Effect Of Low-dose Ketamine On Stress Reaction In Patients Undergoing Abdominohysterectomy

Objective:To evaluate the effect of low-dose ketamine on stress reaction in patients undergoing abdominohysterectomy.Methods:60patients undergoing elective abdominohysterectomy, ASA grade I or II, were randomly divided into two groups:control group(n=30,C group) and ketamine group(n=30, K group). All patients were treated with total intravenous anesthesia(TIVA) induction and maintainance of anesthesia with the same procedures. Patients in C group were given normal saline while K group received injection of ketamine0.5mg/kg intravenously at induction.Blood samples were taken before anaesthesia(To),before cutting open the peritoneum(T1),30min after cutting open the peritoneum(T2), and15min after removal of LMA (T3) to determine the following signs:BG,Cor and IL-6while monitoring hemodynamic parameters.Intraoperative awareness was recorded the next day.Results:(1)No statistical significance was detected of signs from two groups before anesthesia (P>0.05).(2)There were no significant differences in hemodynamic parameters at T1、T2and T3compared toTo in both groups (P>0.05).There were no significant differences between two groups in hemodynamic parameters at various time points(P>0.05).(3) The levels of BG and Cor at T2and T3significantly increased in both groups compared to To (P<0.05), and were significantly lower in group K than in group C (P<0.05).(4) The plasma levels of IL-6at T2and T3significantly increased in group C compared to To (P<0.05) while changes of IL-6in group K were not significantly different(P>0.05)and significantly lower than those in group C(P<0.05).(5) None of the patients reported awareness.Conclusion:Low-dose ketamine given intravenously during total intravenous anesthesia does not influence hemodynamics of patients. From the neuroendocrine,low-dose ketamine can exert antinociceptive effect and reduce the stress reaction to operation stimulation.Low-dose ketamine can suppress the inflammatory cytokines production caused by tissue damage and reduce the stress reaction of the body.