Ketamine infusion versus single bolus for prevention of tourniquet-induced hypertension

A randomized controlled trial

Research output: Contribution to journalArticle

Abstract

Background: The prolonged use of a tourniquet can cause tourniquet-induced hypertension (TIH). Low dose ketamine has been shown to prevent the incidence of TIH. This prospective double blind study was carried out to compare the effectiveness of ketamine infusion versus single bolus in preventing TIH. Method: Patients were randomized into two groups: Group B (ketamine bolus 0.2 mg/kg followed by saline infusion) and Group I (ketamine bolus 0.2 mg/kg followed by 2 µg/kg/min infusion). A study drug bolus was given prior to tourniquet inflation and infusion was started at time of tourniquet inflation. Systolic/diastolic blood pressure and heart rate relative to tourniquet inflation and deflation were recorded at 10 minute intervals. Incidence of TIH and ketamine related side effects at 30 minutes and 24 hours post-surgery were recorded. Results: Fifty two patients were analyzed up to 110 minutes of tourniquet inflation. The changes in hemodynamics between Groups B and I were comparable to each other. TIH occurred in Group B only (15.4%) but this was not statistically significant (p = 0.114). Two patients in Group I developed ketamine related side effects at 30 minutes post surgery. Conclusion: Ketamine bolus followed by ketamine infusion was found to be comparable to a single bolus ketamine bolus given prior to tourniquet inflation in reducing the incidence of TIH among patients undergoing lower limb surgery under general anesthesia.

Original languageEnglish
Pages (from-to)187-193
Number of pages7
JournalMiddle East Journal of Anesthesiology
Volume24
Issue number3
Publication statusPublished - 1 Oct 2017

Fingerprint

Tourniquets
Ketamine
Randomized Controlled Trials
Hypertension
Economic Inflation
Incidence
Blood Pressure
Double-Blind Method
General Anesthesia
Lower Extremity
Heart Rate
Hemodynamics

Keywords

  • General anesthesia
  • Hypertension
  • Ketamine
  • Tourniquet
  • Tourniquet-induced hypertension

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

@article{020c32f4851742dc8f63fc4cd3ecf211,
title = "Ketamine infusion versus single bolus for prevention of tourniquet-induced hypertension: A randomized controlled trial",
abstract = "Background: The prolonged use of a tourniquet can cause tourniquet-induced hypertension (TIH). Low dose ketamine has been shown to prevent the incidence of TIH. This prospective double blind study was carried out to compare the effectiveness of ketamine infusion versus single bolus in preventing TIH. Method: Patients were randomized into two groups: Group B (ketamine bolus 0.2 mg/kg followed by saline infusion) and Group I (ketamine bolus 0.2 mg/kg followed by 2 µg/kg/min infusion). A study drug bolus was given prior to tourniquet inflation and infusion was started at time of tourniquet inflation. Systolic/diastolic blood pressure and heart rate relative to tourniquet inflation and deflation were recorded at 10 minute intervals. Incidence of TIH and ketamine related side effects at 30 minutes and 24 hours post-surgery were recorded. Results: Fifty two patients were analyzed up to 110 minutes of tourniquet inflation. The changes in hemodynamics between Groups B and I were comparable to each other. TIH occurred in Group B only (15.4{\%}) but this was not statistically significant (p = 0.114). Two patients in Group I developed ketamine related side effects at 30 minutes post surgery. Conclusion: Ketamine bolus followed by ketamine infusion was found to be comparable to a single bolus ketamine bolus given prior to tourniquet inflation in reducing the incidence of TIH among patients undergoing lower limb surgery under general anesthesia.",
keywords = "General anesthesia, Hypertension, Ketamine, Tourniquet, Tourniquet-induced hypertension",
author = "Buntar, {Wardina S.} and Nurlia Yahya and {Wan Mat}, {Wan Rahiza} and Azarinah Izaham and Shereen, {Tang Suet Ping} and Zainuddin, {Muhammad Zurrusydi} and Esa Kamaruzaman and {Abdul Manap}, Norsidah",
year = "2017",
month = "10",
day = "1",
language = "English",
volume = "24",
pages = "187--193",
journal = "Middle East Journal of Anesthesiology",
issn = "0544-0440",
publisher = "American University of Beirut",
number = "3",

}

TY - JOUR

T1 - Ketamine infusion versus single bolus for prevention of tourniquet-induced hypertension

T2 - A randomized controlled trial

AU - Buntar, Wardina S.

AU - Yahya, Nurlia

AU - Wan Mat, Wan Rahiza

AU - Izaham, Azarinah

AU - Shereen, Tang Suet Ping

AU - Zainuddin, Muhammad Zurrusydi

AU - Kamaruzaman, Esa

AU - Abdul Manap, Norsidah

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Background: The prolonged use of a tourniquet can cause tourniquet-induced hypertension (TIH). Low dose ketamine has been shown to prevent the incidence of TIH. This prospective double blind study was carried out to compare the effectiveness of ketamine infusion versus single bolus in preventing TIH. Method: Patients were randomized into two groups: Group B (ketamine bolus 0.2 mg/kg followed by saline infusion) and Group I (ketamine bolus 0.2 mg/kg followed by 2 µg/kg/min infusion). A study drug bolus was given prior to tourniquet inflation and infusion was started at time of tourniquet inflation. Systolic/diastolic blood pressure and heart rate relative to tourniquet inflation and deflation were recorded at 10 minute intervals. Incidence of TIH and ketamine related side effects at 30 minutes and 24 hours post-surgery were recorded. Results: Fifty two patients were analyzed up to 110 minutes of tourniquet inflation. The changes in hemodynamics between Groups B and I were comparable to each other. TIH occurred in Group B only (15.4%) but this was not statistically significant (p = 0.114). Two patients in Group I developed ketamine related side effects at 30 minutes post surgery. Conclusion: Ketamine bolus followed by ketamine infusion was found to be comparable to a single bolus ketamine bolus given prior to tourniquet inflation in reducing the incidence of TIH among patients undergoing lower limb surgery under general anesthesia.

AB - Background: The prolonged use of a tourniquet can cause tourniquet-induced hypertension (TIH). Low dose ketamine has been shown to prevent the incidence of TIH. This prospective double blind study was carried out to compare the effectiveness of ketamine infusion versus single bolus in preventing TIH. Method: Patients were randomized into two groups: Group B (ketamine bolus 0.2 mg/kg followed by saline infusion) and Group I (ketamine bolus 0.2 mg/kg followed by 2 µg/kg/min infusion). A study drug bolus was given prior to tourniquet inflation and infusion was started at time of tourniquet inflation. Systolic/diastolic blood pressure and heart rate relative to tourniquet inflation and deflation were recorded at 10 minute intervals. Incidence of TIH and ketamine related side effects at 30 minutes and 24 hours post-surgery were recorded. Results: Fifty two patients were analyzed up to 110 minutes of tourniquet inflation. The changes in hemodynamics between Groups B and I were comparable to each other. TIH occurred in Group B only (15.4%) but this was not statistically significant (p = 0.114). Two patients in Group I developed ketamine related side effects at 30 minutes post surgery. Conclusion: Ketamine bolus followed by ketamine infusion was found to be comparable to a single bolus ketamine bolus given prior to tourniquet inflation in reducing the incidence of TIH among patients undergoing lower limb surgery under general anesthesia.

KW - General anesthesia

KW - Hypertension

KW - Ketamine

KW - Tourniquet

KW - Tourniquet-induced hypertension

UR - http://www.scopus.com/inward/record.url?scp=85044371910&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044371910&partnerID=8YFLogxK

M3 - Article

VL - 24

SP - 187

EP - 193

JO - Middle East Journal of Anesthesiology

JF - Middle East Journal of Anesthesiology

SN - 0544-0440

IS - 3

ER -