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Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial

OBJECTIVE: The aim of this work is to compared ketamine-based versus fentanyl-based regimens for endotracheal intubation in patients with septic shock undergoing emergency surgery. DESIGN: This was a randomised double-blinded controlled trial. PARTICIPANTS: Patients with septic shock on norepinephri...

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Autores principales: Ali, Hassan, Abdelhamid, Bassant Mohamed, Hasanin, Ahmed M, Amer, Aya Abou, Rady, Ashraf
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Sciendo 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949025/
https://www.ncbi.nlm.nih.gov/pubmed/36844112
http://dx.doi.org/10.2478/rjaic-2021-0017
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author Ali, Hassan
Abdelhamid, Bassant Mohamed
Hasanin, Ahmed M
Amer, Aya Abou
Rady, Ashraf
author_facet Ali, Hassan
Abdelhamid, Bassant Mohamed
Hasanin, Ahmed M
Amer, Aya Abou
Rady, Ashraf
author_sort Ali, Hassan
collection PubMed
description OBJECTIVE: The aim of this work is to compared ketamine-based versus fentanyl-based regimens for endotracheal intubation in patients with septic shock undergoing emergency surgery. DESIGN: This was a randomised double-blinded controlled trial. PARTICIPANTS: Patients with septic shock on norepinephrine infusion scheduled for emergency surgery. SETTING AND INTERVENTIONS: At induction of anaesthesia, patients were allocated into ketamine group (n=23) in which the participants received ketamine 1 mg/kg, and fentanyl group (n=19) in which the participants received fentanyl 2.5 mcg/ kg. Both groups received midazolam (0.05 mg/kg) and succinyl choline (1 mg/kg). MEASUREMENT: The primary outcome was mean arterial blood pressure. The secondary outcomes included: heart rate, cardiac output, and incidence of postintubation hypotension defined as mean arterial pressure ≤80% of baseline value. RESULTS: Forty-two patients were available for final analysis. The mean blood pressure was higher in the ketamine group than in the fentanyl group at 1, 2 and 5 minutes after the induction of anaesthesia. Furthermore, the incidence of postinduction hypotension was lower in the ketamine group than in the fentanyl group (11 [47.8%] versus 16 [84.2%], P-value= 0.014). Other hypodynamic parameters, namely the heart rate and cardiac output, were comparable between both groups; and were generally maintained in relation to the baseline reading in each group. CONCLUSION: The ketamine-based regimen provided better hemodynamic profile compared to fentanyl-based regimen for rapid-sequence intubation in patients with septic shock undergoing emergency surgery.
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spelling pubmed-99490252023-02-24 Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial Ali, Hassan Abdelhamid, Bassant Mohamed Hasanin, Ahmed M Amer, Aya Abou Rady, Ashraf Rom J Anaesth Intensive Care Original Paper OBJECTIVE: The aim of this work is to compared ketamine-based versus fentanyl-based regimens for endotracheal intubation in patients with septic shock undergoing emergency surgery. DESIGN: This was a randomised double-blinded controlled trial. PARTICIPANTS: Patients with septic shock on norepinephrine infusion scheduled for emergency surgery. SETTING AND INTERVENTIONS: At induction of anaesthesia, patients were allocated into ketamine group (n=23) in which the participants received ketamine 1 mg/kg, and fentanyl group (n=19) in which the participants received fentanyl 2.5 mcg/ kg. Both groups received midazolam (0.05 mg/kg) and succinyl choline (1 mg/kg). MEASUREMENT: The primary outcome was mean arterial blood pressure. The secondary outcomes included: heart rate, cardiac output, and incidence of postintubation hypotension defined as mean arterial pressure ≤80% of baseline value. RESULTS: Forty-two patients were available for final analysis. The mean blood pressure was higher in the ketamine group than in the fentanyl group at 1, 2 and 5 minutes after the induction of anaesthesia. Furthermore, the incidence of postinduction hypotension was lower in the ketamine group than in the fentanyl group (11 [47.8%] versus 16 [84.2%], P-value= 0.014). Other hypodynamic parameters, namely the heart rate and cardiac output, were comparable between both groups; and were generally maintained in relation to the baseline reading in each group. CONCLUSION: The ketamine-based regimen provided better hemodynamic profile compared to fentanyl-based regimen for rapid-sequence intubation in patients with septic shock undergoing emergency surgery. Sciendo 2022-12-29 /pmc/articles/PMC9949025/ /pubmed/36844112 http://dx.doi.org/10.2478/rjaic-2021-0017 Text en © 2021 Ali et al., published by Sciendo https://creativecommons.org/licenses/by-nc-nd/3.0/This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
spellingShingle Original Paper
Ali, Hassan
Abdelhamid, Bassant Mohamed
Hasanin, Ahmed M
Amer, Aya Abou
Rady, Ashraf
Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial
title Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial
title_full Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial
title_fullStr Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial
title_full_unstemmed Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial
title_short Ketamine-based Versus Fentanyl-based Regimen for Rapid-sequence Endotracheal Intubation in Patients with Septic Shock: A Randomised Controlled Trial
title_sort ketamine-based versus fentanyl-based regimen for rapid-sequence endotracheal intubation in patients with septic shock: a randomised controlled trial
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9949025/
https://www.ncbi.nlm.nih.gov/pubmed/36844112
http://dx.doi.org/10.2478/rjaic-2021-0017
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