To evaluate the effect of combination of lidocaine and ketamine infusion on attenuation of hemodynamic response to intubation,skin incision and sternotomy in open adult valvular heart surgeries.A double blinded randomized controlled study.

Hemodynamic stability is crucial during cardiac surgery to ensure adequate organ perfusion and improve outcomes. Surgical stimuli such as laryngoscopy, intubation, skin incision, and sternotomy can provoke significant sympathetic responses, leading to increased heart rate and blood pressure—potentially harmful in patients with heart disease. Conventional drugs have limited success in attenuating these responses. Lidocaine and ketamine, due to their analgesic, anti-inflammatory, and cardiovascular properties, may help stabilize intraoperative hemodynamics and reduce anesthetic requirements. However, limited data exist on their effects during open valvular heart surgeries. This study aims to evaluate their efficacy in blunting hemodynamic responses during such procedures.