Lidocaine as an Adjuvant for Ketamine in Induction of Anesthesia in Septic Shock Patients
- Conditions
- Septic ShockAnesthesia
- Interventions
- Registration Number
- NCT03640468
- Lead Sponsor
- Cairo University
- Brief Summary
The aim of the work is to investigate the effect of using lidocaine in combination with low dose ketamine in induction of anesthesia for septic shock patients compared to normal dose of ketamine.
- Detailed Description
Most of the drugs used for induction of anesthesia negatively impact patient hemodynamics. Thus, induction of anesthesia in shocked patients might result in deleterious hypotension. Patients with severe sepsis and septic shock frequently need surgical interventions. The best protocol for induction of anesthesia in septic shock patients is lacking.
Ketamine is an agent used for induction of anesthesia with known positive cardiovascular effects. However, these positive effects were reported in individuals with intact sympathetic nervous system. Invitro studies showed that ketamine direct action on the cardiac muscles is negative. Thus, it had been recommended that ketamine should be used with caution in hemodynamically vulnerable patients till further randomized controlled trials are present.
Lidocaine is a drug with multiple local and systemic uses. Having local anesthetic properties, lidocaine was proposed to have an anesthetic sparing effect. Lidocaine was previously reported to enhance the hypnotic effect of thiopentone, propofol, and midazolam during induction of anesthesia. Lidocaine showed a sparing effect for volatile as well as intravenous requirements for maintenance of anesthesia; thus, we hypothesize that its use as an adjuvant during induction of anesthesia in septic shock patient could provide a sparing effect for ketamine and minimize its negative circulatory sequelae.
Recruitment & Eligibility
- Status
- UNKNOWN
- Sex
- All
- Target Recruitment
- 36
- Adult patients aged above 18 years
- With septic shock
- Scheduled for general anesthesia
- Patients under 18 years
- Burn patients
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Ketamine group Ketamine full dose This group will receive induction of anesthesia using ketamie full dose 1 mg/kg, midazolam 0.05 mg/Kg, and normal saline 10 mL. Ketamine group Normal saline This group will receive induction of anesthesia using ketamie full dose 1 mg/kg, midazolam 0.05 mg/Kg, and normal saline 10 mL. Lidocaine-ketamine group Ketamine half dose This group will receive induction of anesthesia using Ketamie half dose 0.5 mg/kg, midazolam 0.05 mg/Kg, and lidocaine 1 mg/Kg. Lidocaine-ketamine group Midazolam This group will receive induction of anesthesia using Ketamie half dose 0.5 mg/kg, midazolam 0.05 mg/Kg, and lidocaine 1 mg/Kg. Ketamine group Midazolam This group will receive induction of anesthesia using ketamie full dose 1 mg/kg, midazolam 0.05 mg/Kg, and normal saline 10 mL. Lidocaine-ketamine group Lidocaine This group will receive induction of anesthesia using Ketamie half dose 0.5 mg/kg, midazolam 0.05 mg/Kg, and lidocaine 1 mg/Kg.
- Primary Outcome Measures
Name Time Method Mean arterial pressure 10 minutes after induction of general anesthesia Mean arterial pressure measured in mmHg
- Secondary Outcome Measures
Name Time Method Heart rate 10 minutes after induction of general anesthesia number of heart beats per minutes
Cardiac output 10 minutes after induction of general anesthesia volume of blood pumped by the heart in one minute measured in liters per minute
The number of patients who suffer from decreased mean arterial pressure by 20% from the baseline reading after induction of anesthesia 10 minutes after induction of general anesthesia Norepinephrine consumption 10 minutes after induction of general anesthesia The total dose of norepinephrine measured in micrograms
Trial Locations
- Locations (1)
Cairo University
🇪🇬Cairo, Egypt