Effect of low-dose ketamine on post-operative serum IL-6 production among elective surgical patients: a randomized clinical trial
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Date
2017
Journal Title
Journal ISSN
Volume Title
Publisher
African Health Sciences
Abstract
Surgery and Anesthesia cause an excessive pro-inflammatory response. Mulago Hospital is faced with staff shortage
making post-operative pain management difficult.Interleukin-6 (IL-6) drives inflammatory pain, endothelial cell dysfunction
and fibrogenesis. Ketamine is cheap and, readily available. We hypothesized that its attenuation of serum IL-6 was a surrogate
for clinical benefit.
Materials and methods: Institutional Review Board’s approval was sought and RCT was registered at clinical trials.gov (identifier
number: NCT01339065). Consenting patients were randomized to receive pre-incision intravenous ketamine - 0.5mg/kg
or 0.9% saline placebo in weighted dosing. Blood samples were collected and laboratory analyzed at baseline, post-operatively in
PACU, 24 and 48 hours respectively.
Results: We recruited 39 patients of whom 18 were randomized to the ketamine arm and 21 in the placebo arm with follow up
at 24 and 48 hours. Serum IL-6 and IL-1β levels were analyzed using ELIZA assay of pre-coated micro wells. Ketamine suppressed serum IL-6 at PACU with reduced increase at 24 hours. There was no reaction in 98% of IL-1β assayed.
Conclusion: Low-dose ketamine attenuated early serum IL-6 levels due to surgical response with reduced 24 hour increase, but
the difference was not statistically significant and we recommend more studies
Description
Keywords
Ketamine, post-operative inflammation, interleukin 6
Citation
Luggya, T. S., Roche, T., Ssemogerere, L., Kintu, A., Kasumba, J. M., Kwizera, A., & Tindimwebwa, J. V. (2017). Effect of low-dose ketamine on post-operative serum IL-6 production among elective surgical patients: a randomized clinical trial. African Health Sciences, 17(2), 500-507.DOI: https://dx.doi.org/10.4314/ahs.v17i2.25