الفهرس Only 14 pages are availabe for public view
 |  | from | 279 |  |  |
| | | from | 279 | | |
Abstract
There is an interest in the use of Propofol anesthesia in cardiac surgery, because experimental and clinical studies have suggested that it attenuates the response to surgical stress and improves myocardial metabolism thus enabling earlier extubation and a smoother postoperative course.
Matters of major concern in the adoption of Ketamine anesthesia in cardiac surgery are hemodynamic instability and hallucinations.
There are limted number of ICU beds, In this context it is advisable to use IV anesthetic drugs that have rapid pharmacologic onset and offset, leading to rapid awakening and thus allowing prompt extubation and discharge.
After ethical committee approval and informed consent from patients, this prospective randomized study was carried out in Ain Shams university hospital on 60 patients scheduled for elective CABG. They were randomly allocated into 2 equal groups 30 patients each.
Group I: Patients received Propofol and Ketamine combination for induction and maintenance of anesthesia.
Group II: Patients received Isoflurane and high dose Fentanyl anesthesia.
In this study the beneficial effects of Propofol - ketamine anesthesia on cardiac outcome, reduction of the stress response, pain control, and finally length of ICU stay was studied.
Propofol - ketamine anesthesia was found to be superior over opioid based general anesthesia in providing hemodynamic stability with minimal undesirable side effects. Propofol - ketamine anesthesia also yielded a better myocardial outcome as evidenced by lower ischemic manifestations and lower cardiac enzymes.
Finally the use of Propofol - ketamine anesthesia probably reduced the needs of additional analgesics as it offered adequate pain control in the postoperative period, this lead to early extubation, and subsequently shorter ICU stay.
The use of Propofol - ketamine anesthesia technique may provide better outcome in patients undergoing coronary artery revascularization with minimal complications, yet more studies and a long term follow up of those patients is to be considered.