Open Heart Surgery Clinical Trial
Official title:
Neuroprotection During Open Heart Surgery Propofol Versus Ketofol
Millions of individuals with coronary artery, or valvular heart disease have been given a new
chance at life by heart surgery, but the potential for neurological injury is a great risk
.Neural complications - including neurocognitive dysfunction and ischemic complications are
complications of cardiac surgery that can restrict the improved quality of life.
Propofol is one of the most popular agents used for induction of anesthesia. propofol reduces
cerebral blood flow but maintains coupling with cerebral metabolic rate for oxygen and
decreases intracranial pressure, allowing optimal intraoperative conditions.
Ketamine is a non-competitive antagonist of NMDA receptors that has well documented
neuroprotective effects against ischemic brain injury and glutamate-induced brain injury.
ketamine has neuroprotective effects against oxygen-glucose deprivation injury
The aim of the study is to evaluate neuroprotective effect of mixture of propofol and
ketamine (ketofol) as compared to propofol after open heart surgery.
Induction;
- Pre-oxygenation with100% O2 for 3 min.
- Morphine 0.1-0.15 mg/kg
- Fentanyl, dose 3-5 mcg/kg.
- hypnotic agent differs for each group:
- Propofol group: Propofol, dose 0.5-2 mg/kg.
- Ketofol group: Ketofol,( dose 0.25-1 mg/kg propofol plus 0.25-1 mg/kg ketamine diluted
in normal saline with maintained 1:1 ratio between propofol and ketamine. )
Catheterization:
1. Central venous catheter: A suitable central venous catheter will be inserted into Right
subclavian vein under complete aseptic technique using seldinger technique.
2. Jugular bulb catheterization: Patients is placed in supine position with mild neck
extension. The head is placed in neutral position with mild tilt to the opposite side of
insertion. Under complete aseptic conditions, the anatomical landmarks for the right
internal jugular vein will be identified (at the level of cricoid cartilage, medial to
the sternomastoid muscle and lateral to a palpable internal carotid artery). The
internal jugular vein will be then cannulated by retrograde insertion of a catheter for
sampling of the jugular venous bulb blood. Catheter will be advanced till resistance of
the skull base is reached then withdrawn about 1 to 2 mm.
Position of the catheter will be confirmed by antero-posterior and lateral neck C-arm x-ray
to verify the correct placement of the catheter tip in the will be sutured to the skin and
dressed with sterile gauze
;
Status | Clinical Trial | Phase | |
---|---|---|---|
Recruiting |
NCT06203184 -
The Effect of Video Game-Based Exercises After Open Heart Surgery
|
N/A | |
Not yet recruiting |
NCT03806413 -
Post-surgical Delirium in Patients Undergoing Open Heart Surgery.
|
||
Recruiting |
NCT04670367 -
The Effects of Baduanjin Exercise on Meridian Energy and Heart Rate Variability in Patients Undergoing Cardiac Sugery
|
N/A | |
Terminated |
NCT04506762 -
Benefit of Peri-operative Bilateral ESP Catheters for Enhanced Recovery for Cardiac Surgery (ERCS)
|
N/A | |
Completed |
NCT05316207 -
Tele-Nursing Follow-Up After Open Heart Surgery
|
N/A | |
Completed |
NCT06436872 -
The Effect of Informing the Relatives of Patients Undergoing Open Heart Surgery
|
N/A | |
Recruiting |
NCT05441358 -
Assessment of Platelet Function in Patients Undergoing Open Heart Surgery
|
||
Not yet recruiting |
NCT05715060 -
Sternal Closure in Children After Cardiac Surgery
|
N/A | |
Not yet recruiting |
NCT05222256 -
Comparison Between Levosimendan and Adrenaline in CABG Patients
|
N/A | |
Completed |
NCT03105089 -
Effect of Cardiac Preconditioning Upon the Inotrope Score
|
N/A | |
Completed |
NCT05149235 -
Gaming Technology and Cardiac Rehabilitation
|
N/A | |
Completed |
NCT03106818 -
Postoperative Pain Alleviation in Open Heart Surgery
|
N/A | |
Completed |
NCT01069562 -
Closed Loop Isoflurane Administration With Bispectral Index in Open Heart Surgery
|
N/A | |
Recruiting |
NCT05522712 -
Acapella Versus Incentive Spirometer on Cardiopulmonary Fitness After Heart Valve Surgery.
|
N/A | |
Completed |
NCT04213040 -
Procalcitonin and Postoperative Outcome After Open-heart Surgery
|
||
Completed |
NCT06165861 -
The Effect of Using Virtual Reality Glasses on Surgical Fear and Anxiety
|
N/A | |
Active, not recruiting |
NCT03955536 -
Comparison of the Effects of Different Physiotherapy and Rehabilitation Methods on Open Heart Surgery
|
N/A | |
Recruiting |
NCT06168799 -
Ilofotase Alfa for Prevention of Renal Damage After Cardiac Surgery
|
Phase 2 | |
Recruiting |
NCT03799965 -
The Effect of Advanced Improvement Program (ERAS) on Postoperative Outcomes in Patients Undergoing Open Heart Surgery
|
N/A | |
Completed |
NCT05932368 -
Early Evaluation After Cardiac Surgery
|