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The use of ketamine as an induction agent for anesthesia in pulmonary thromboendarterectomy surgery: A case series


1 Department of Anaesthesia, Royal Papworth Hospital, Cambridge, UK
2 Department of Cardiac Surgery, Royal Papworth Hospital, Cambridge, UK
3 Department of Anaesthesiology, Singapore General Hospital; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore, Singapore

Correspondence Address:
Andrew Roscoe
Department of Anaesthesiology, Singapore General Hospital, Outram Road
Singapore
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.aca_24_21

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Year : 2022  |  Volume : 25  |  Issue : 4  |  Page : 528-530

 

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Pulmonary thromboendarterectomy (PTE) surgery is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The induction of anesthesia in patients with severe pulmonary hypertension (PHT) can be challenging, with a risk of cardiovascular collapse. The administration of ketamine in patients with PHT is controversial, with some recommendations contraindicating its use. However, ketamine has been used safely in children with severe PHT. We present a retrospective case series of adult patients with severe PHT presenting for PTE surgery, using intravenous ketamine as a co-induction anesthetic agent.






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1 Department of Anaesthesia, Royal Papworth Hospital, Cambridge, UK
2 Department of Cardiac Surgery, Royal Papworth Hospital, Cambridge, UK
3 Department of Anaesthesiology, Singapore General Hospital; Department of Cardiothoracic Anaesthesia, National Heart Centre, Singapore, Singapore

Correspondence Address:
Andrew Roscoe
Department of Anaesthesiology, Singapore General Hospital, Outram Road
Singapore
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/aca.aca_24_21

Rights and Permissions

Pulmonary thromboendarterectomy (PTE) surgery is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The induction of anesthesia in patients with severe pulmonary hypertension (PHT) can be challenging, with a risk of cardiovascular collapse. The administration of ketamine in patients with PHT is controversial, with some recommendations contraindicating its use. However, ketamine has been used safely in children with severe PHT. We present a retrospective case series of adult patients with severe PHT presenting for PTE surgery, using intravenous ketamine as a co-induction anesthetic agent.






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