The effects of dexmedetomidine and ketamine infusions on the inflammatory response in liver resection: A randomized double-blind placebo study.

BACKGROUND

This study compared the effects of ketamine and dexmedetomidine (Dex) on inflammation and pain in liver resection surgery.

METHODS

Forty-five American Society of Anesthesiologists class III patients aged 18 to 65 scheduled for liver resection surgery were randomized into 3 equal groups. The ketamine group received an intravenous ketamine bolus (0.5 mg/kg) during anesthesia induction and continuous low-dose infusion at 0.25 mg/kg/hour. In the Dex group, intravenous infusion was initiated at a 1 µg/kg bolus for the first 10 minutes, and at 0.5 µg/kg/hour after intubation. The control group patients were infused crystalloid solution at 8 mL/kg/hour from induction. Venous blood was collected at postoperative hours 1 and 12 for pentraxin 3, serum amyloid A, hepcidin, and inflammatory marker analysis. Visual analogue scale (VAS) values were recorded.

RESULTS

Pentraxin 3, serum amyloid A, and hepcidin continued to rise at 12 hours in the control group, but began declining in the Dex and ketamine infusion groups (P < .05). VAS levels and fentanyl consumption decreased in the ketamine and Dex groups compared to the control group (P < .05). The decreases in inflammatory parameters, VAS scores, and fentanyl consumption were similar between the ketamine and Dex groups (P > .05). A positive correlation was observed between inflammation levels and pain severity (P < .001). There was no difference in liver function tests between any of the groups (P < .05).

CONCLUSION

Ketamine and Dex infusions were both effective in reducing inflammation and pain following liver resection, with no obvious superiority of one over the other.