الفهرس | Only 14 pages are availabe for public view |
Abstract Induction of anesthesia in hemodynamically compromised patients is a challenge for every anesthetist. Most of the intravenous induction agents have a negative effect on arterial blood pressure and cardiac output. Theoretically, the ideal emergency induction intravenous anesthetic should achieve rapid hypnosis and maintain the hemodynamic stability 3. Ketamine has been reported as an induction anesthetic with a sympathomimetic activity 3. In patients with intact autonomic nervous system ketamine increases heart rate, cardiac output, and arterial blood pressure (ABP) 2. Despite its sympathomimetic activity in hemodynamically stable patients 2, the hemodynamic response to ketamine in unstable cardiovascular conditions is not clear. Ketamine was reported to exert a direct dose-dependent negative inotropic effect in both failing and non-failing human cardiac muscles in vitro 4. According to animal studies, ketamine was associated with stable hemodynamic profile when used for induction 97 and maintenance of anesthesia 6 in animal models of hemorrhagic shock. No studies to the best of our knowledge compared Ketamine and low dose thiopental in rapid sequence induction of anesthesia in hemodynamically unstable patients |