RESEARCH ARTICLE


Effect of Ketamine on Inflammatory and Immune Responses After Short-Duration Surgery in Obese Patients



Efim Roussabrov1, Joanna M. Davies2, Hana Bessler3, Lev Greemberg1, Leonid Roytblat1, Israel-Zeev Yardeni4, Alan A. Artru*, 2, Yoram Shapira1
1 Division of Anesthesiology, Soroka Medical Center, Faculty of Health Science, Ben-Gurion University of the Negev, Beer-Sheva, Israel
2 Department of Anesthesiology, University of Washington, Seattle, WA, USA
3 Research Institute, and
4 Department of Anesthesiology, Rabin Medical Center, Golda Campus (Hasharon), Petah Tiqva and The Sackler School of Medicine, Tel-Aviv University Ramat Aviv, Israel


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Creative Commons License
Roussabrov et al.; Licensee Bentham Open

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Anesthesiology, Box 356540, UWMC, 1959 NE Pacific St., Seattle, WA 98195, USA; Tel: 2065984260; Fax: 2065984544; E-mail: artruaa@u.washington.edu


Abstract

In non-obese patients ketamine decreases inflammatory responses and prevents overexpression of immune responses. Its effect in obese patients is unknown. This prospective, blinded, randomized controlled trial was designed to determine the effect of ketamine on cytokines and immune cell responses after short-duration surgery in obese patients. Thirty-six patients received either ketamine 0.15 mg/kg IV prior to induction of general anesthesia, or an equal volume of normal saline. Cytokine concentrations and immune cell responses were determined pre-operatively and at 4, 24, and 48 h after operation. Interleukin (IL)-6 production was significantly greater in the control group (126.0 ± 18.8 ng/ml, mean ± SEM, n = 19) than in the ketamine group (57.9 ± 8.4 ng/ml) at 4 h. At other time periods IL-6 and tumor necrosis factor α increased and IL-2, lymphocyte proliferation, and natural killer cell cytotoxity decreased compared to pre-operative values in the control group but not in the ketamine group. We conclude that effects of ketamine on inflammatory and immune responses after short-duration surgery in obese patients are similar to those previously reported in non-obese patients.

Keywords: Ketamine, cytokines, interleukins, inflammation, immune response.