The benefit of adding lidocaine to ketamine during rapid sequence endotracheal intubation in patients with septic shock: A randomised controlled trial

Fathy, Shymaa; Hasanin, Ahmed; Mostafa, Maha; Ramzy, Ezzat; Sarhan, Khaled; Almenesey, Tarek; Safina, Ahmed G; Hosny, Osama; Hamden, Ghada Adel; Gado, Ahmed; Mokhtar, Ali

doi:10.1016/j.accpm.2020.06.017

Cited by 16 publications

(12 citation statements)

References 33 publications

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“…Additionally, ketamine remarkably limits the diapedesis of the neutrophils to the site of in ammation 42 and resolves the in ammatory reaction by promoting immune cell apoptosis and further reducing proin ammatory cytokine release 43 . Moreover, clinical evidence has proved that the severe state of critically ill patients and experimental septic shock could be improved with ketamine intervention 44 . Overall, SIRS is the terminal disease state.…”

Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Ketamine alleviated blood-brain barrier damage and microglia over-activation induced by SIRS via restricting cecum damage and HMGB1 release

Deng

Yang

et al. 2022

Preprint

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Following systemic inflammatory response syndrome (SIRS), the brain is one of the most sensitive organs vulnerable to an external stressor. According to our previous study, ketamine had a protective effect on alleviating SIRS-associated neuronal necroptosis and cecal epithelial cell necroptosis by inhibiting the RIP1-RIP3-MLKL pathway. In this study, we further provided valid evidence that ketamine could safeguard the integrity of the blood-brain barrier (BBB), modulate microglia over-activation, and prevent neural network damage, resulting in relieving cerebral edema and improving system symptoms significantly. Simultaneously, cecum damage was partly reversed by ketamine intervention, which was attributed to a decrease in circulating high mobility group protein 1 (HMGB1). Interestingly, the result showed less cecum injury and relieved BBB disturbance in Rip3-/- mice. Furthermore, circulating HMGB1 content between Rip3-/- mice and mice with ketamine intervention significantly decreased. Moreover, anti-HMGB1 neutralizing antibody identically reversed BBB damage, indicating that cecum-promoted HMGB1 releases extravagated SIRS and BBB leakage. In addition, we clarified that cecectomy reduced serum HMGB1 release level and alleviated BBB damage and microglial activation. Altogether, our work shed light on the new view about the pathogenesis of SIRS, establishing the connection between cecum damage and BBB damage. Besides, we identified ketamine as a candidate to protect the brain from damage like BBB leakage and microglia over-activation, which attributed to the effect on alleviating cecum damage and decreasing circulation HMGB1 release. Our results provided a new theoretical view and therapeutic target for the application of ketamine in SIRS.

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Section: Discussionmentioning

confidence: 99%

WITHDRAWN: Ketamine alleviated blood-brain barrier damage and microglia over-activation induced by SIRS via restricting cecum damage and HMGB1 release

Deng

Yang

et al. 2022

Preprint

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“…Lastly, the cardiac output was assessed noninvasively using electric cardiometry. Electric cardiometry-derived absolute cardiac output values were reported as not interchangeable with the thermodilution method [ 27 ]; however, electric cardiometry had acceptable trending ability [ 28 ]; thus, it was used to follow-up the changes in the cardiac output in various populations [ 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Hemodynamic effects of norepinephrine versus phenylephrine infusion for prophylaxis against spinal anesthesia-induced hypotension in the elderly population undergoing hip fracture surgery: a randomized controlled trial

Mostafa

Hasanin

Mahmoud

et al. 2021

Korean J Anesthesiol

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Background: Elderly population are at increased risk of spinal anesthesia-induced hypotension increasing their risk for postoperative morbidity and mortality. This study aimed to compare the hemodynamic effects of prophylactic infusion of norepinephrine (NE) versus phenylephrine (PE) in elderly patients undergoing hip fracture surgery under spinal anesthesia. Methods: Elderly patients scheduled for hip fracture surgery were randomized to receive either NE infusion (8 µg/min) (NE group, n = 31) or PE infusion (100 µg/min) (PE group, n = 31) after spinal anesthesia. Outcomes included mean heart rate, mean blood pressure, cardiac output, incidence of spinal anesthesia-induced hypotension, incidence of bradycardia, and incidence of hypertension. Results: Sixty-two patients with a mean age of 71 ± 6 years were included in the final analysis (31 patients in each group). The NE group showed a higher mean heart rate and cardiac output than the PE group. The NE group had a lower incidence of reactive bradycardia (10% vs. 36%, P = 0.03) and hypertension (3% vs. 36%, P = 0.003) than the PE group. No study participant developed hypotension, and the mean blood pressure was comparable between the two groups. Conclusions: Both NE and PE infusions effectively prevented spinal anesthesia-induced hypotension in elderly patients undergoing hip fracture surgery. However, NE provided more hemodynamic stability than PE; maintaining the heart rate, higher cardiac output, less reactive bradycardia, and hypertension.

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“…It was reported that intravenous infusion of lidocaine could blunt the hemodynamic response to endotracheal intubation during induction of anaesthesia [21]. Hypotension is a common complication after induction of general anaesthesia and lidocaine-ketamine combination could significant decrease incidence of hypotension compared to ketamine when used for endotracheal intubation in patients with circulatory failure [22].Our study found that the fluctuation of MAP and HR after gastroscopy implanted in group L were lower than those in group S. In addition, IV lidocaine can reduce the incidence of cough in patients undergoing gastroscopy. A meta-analysis has shown that intravenous lidocaine may be a best chose to decrease emergence coughing during anesthesia recovery and endotracheal tube pulled out in adult elective surgery [23].Furthermore, IV lidocaine may exert central anti-nociceptive effects by action on muscarinic and nicotinic receptors, which reinforce the inhibitory descending pain pathway in rats experiment [24].These findings in our study showed that lidocaine could stabilize the hemodynamic fluctuation after gastroscopy implanted, and reduce the incidence of intraoperative cough.…”

Section: Discussionmentioning

confidence: 99%

Intravenous lidocaine Increases the Efficacy of Propofol Anesthesia for Gastroscope Implanted:A Randomised, Double-blind, Controlled Study

Fu¹,

Chen²,

Ren³

et al. 2021

Preprint

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Backgroud: Gastroscope insertion is a distressing experience and propofol use for sedation can result in inhibition of circulation and respiration. Intravenous (IV) infusion of lidocaine has been shown to reduce propofol requirements during surgery.The goal of this study was to evaluate the impact of IV lidocaine on the median effective dose (ED50) of propofol and other outcomes after surgery. Method: Ninety adult patients undergoing analgesic gastroscopy were randomly divided into two groups (45 cases in each). The lidocaine group was slowly injected with 1% lidocaine at 1.5mg/kg while the saline group was given the same volume of saline before propofol induction. Motion and cough reaction were regarded as the judgment index of gastroscope implanted. The dose-response curves were made in the two groups when implanted gastroscope according to the formula of Y=Ymin+(Ymax-Ymin)/[1+10 log(ED50-X)*m ]. The primary outcome were the ED50 and requirement of propofol. Secondary outcomes were:intraoperative hemodynamic parameters,adverse reaction,awakening time,post-operative pain and fatigue. Results: Compared with the group S, the dose-response curve showing percentage of gastroscope implanted after propofol anesthesia in the L group shifted to the left. Intravenous infusion of lidocaine decreased the ED50 of propofol (group S 1.80mg/kg, group L 1.56mg/kg).Compared with group S, induction, additional requirement and total dose of propofol anesthesia, and incidence of bucking were significantly reduced in group L (P<0.05). Post-operative fatigue scores in group L were lower than that in group S (P < 0.05). Conclusion: Intravenous lidocaine could reduce the consumption of propofol anesthesia and reduce adverse reaction in patients undergoing painless gastroscopy. Trials registration: ChiCTR2000038542. Data of registration: Sep 23th, 2020.

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The benefit of adding lidocaine to ketamine during rapid sequence endotracheal intubation in patients with septic shock: A randomised controlled trial

Cited by 16 publications

References 33 publications

WITHDRAWN: Ketamine alleviated blood-brain barrier damage and microglia over-activation induced by SIRS via restricting cecum damage and HMGB1 release

WITHDRAWN: Ketamine alleviated blood-brain barrier damage and microglia over-activation induced by SIRS via restricting cecum damage and HMGB1 release

Hemodynamic effects of norepinephrine versus phenylephrine infusion for prophylaxis against spinal anesthesia-induced hypotension in the elderly population undergoing hip fracture surgery: a randomized controlled trial

Intravenous lidocaine Increases the Efficacy of Propofol Anesthesia for Gastroscope Implanted:A Randomised, Double-blind, Controlled Study

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