Septic Shock Clinical Trial
Official title:
Ketamine Versus Low Dose Thiopental for Rapid-sequence Induction of Anesthesia in Patients With Septic Shock
The aim of this work is to compare two protocols (ketamine-fentanyl-midazolam versus thiopental-fentanyl-midazolam) for induction of anesthesia in patients with septic shock aiming to find the most safe protocol with regards to hemodynamic status of patients.
Induction of anesthesia in hemodynamically compromised patients is a challenge for every
anesthetist. Most of the intravenous induction agents have a negative effect on arterial
blood pressure and cardiac output. Theoretically, the "ideal" emergency induction intravenous
anesthetic should achieve rapid hypnosis and maintain the hemodynamic stability Ketamine has
been reported as an induction anesthetic with a sympathomimetic activity. In patients with
intact autonomic nervous system ketamine increases heart rate, cardiac output, and arterial
blood pressure (ABP). Despite its sympathomimetic activity in hemodynamically stable
patients, the hemodynamic response to ketamine in unstable cardiovascular conditions is not
clear No studies to the best of our knowledge compared Ketamine and low dose thiopental in
rapid sequence induction of anesthesia in hemodynamically unstable patients.
In this study, patients with severe sepsis or septic shock scheduled for surgery will be
assigned to receive either ketamine or thiopental for induction of anesthesia. After
induction of anesthesia, endotracheal tube will be inserted aided by succinyl choline.
Invasive blood pressure will be monitored through a transducer connected to arterial
catheter. Electrical velocimetry (cardiometry) device will be used for non-invasive
monitoring of cardiac output and stroke volume.
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