Effect of ketamine combined with lidocaine in pediatric anesthesia

Abstract

Background:We conducted a randomized clinical trial to determine whether adjunctive lidocaine diminishes the incidence of adverse effects in pediatric patients sedated with ketamine. Methods:This case-control study involved 586 consecutive pediatric patients necessitating anesthesia. Then systolic blood pressure, heart rate, respiratory rate, and blood oxygen saturation were observed. Alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea nitrogen (BUN), and creatinine (Cr) levels were tested.General dose of ketamine, the time of onset and duration of anesthesia and postoperative recovery, anesthesia effect, and adverse reaction were subsequently compared. High-performance liquid chromatography was employed to detect ketamine concentration at different time points after administration, and the postoperative cognition function was further evaluated.Results: Intra-and post-operation, the rising degree of ALT, AST, BUN, and Cr in patients treated with ketamine was higher than those in patients treated with the ketamine-lidocaine complex. General dose of ketamine, the time of onset and duration of anesthesia, postoperative recovery time, and the incidence rate of adverse reaction in patients treated with ketamine-lidocaine complex were lower, but the concentration of ketamine was higher compared to the patients treated with ketamine. In patients treated with the ketamine-lidocaine complex, elimination half-life of ketamine was prolonged, the area under curve was increased, and the plasma clearance rate was decreased relative to those with ketamine alone. Conclusions:Ketamine combined with lidocaine may be beneficial in shortening the onset of anesthesia, promoting postoperative awake, prolonging elimination half-life, increasing area under curve, and decreasing plasma clearance rate and incidence of adverse reactions. K E Y W O R D S injectable anesthesia, ketamine, lidocaine, pediatric anesthesia S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section. How to cite this article: Fang H, Li H-F, Yang M, et al. Effect of ketamine combined with lidocaine in pediatric anesthesia. J Clin Lab Anal. 2020;34:e23115. https ://doi.

Total Intravenous Anesthesia with Ketofol versus Combination of Ketofol and Lidocaine for Short-Term Anesthesia in Pediatric Patients; Double Blind, Randomized Clinical Trial of Effects on Recovery

“…In a retrospective analysis of data, in a limited number of pediatric patients undergoing general anesthesia for laparoscopic appendectomy, continuous perioperative administration of intravenous lidocaine did not produce any adverse effects [ 26 ]. Consistent with our study, Fang et al supplied information supporting the use of the ketamine and lidocaine mixture which contributed to more stable vital signs, shorter onset and recovery time, elimination half-life prolonged, increased area under the curve, decreased plasma clearance, dosage and adverse effects [ 27 ]. Our results have shown that TIVA with lidoketofol decreased opioid consumption and shortened the extubating and recovery time.…”

Evaluation of Fibrin-Agarose Tissue-Like Hydrogels Biocompatibility for Tissue Engineering Applications

“…Similarly, Fang and cols. demonstrated a transaminase increase in pediatric patients sedated with ketamine (Fang et al, 2019). Whether or not the grafted FATLH may play a role in AST increase should be determined in future works.…”

Resurgence of combined intravenous Ketamine and regional anesthesia in pediatric ocular surgery in COVID-19 pandemic

“…[ 18 ] Ketamine inhibits morphine metabolism to increase the duration of analgesia, thereby exercising its intrinsic anti-inflammatory effects. [ 19 ]…”