The use of ketamine as an induction agent for anesthesia in pulmonary thromboendarterectomy surgery: A case series

Ann Card Anaesth. 2022 Oct-Dec;25(4):528-530. doi: 10.4103/aca.aca_24_21.

Abstract

Pulmonary thromboendarterectomy (PTE) surgery is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). The induction of anesthesia in patients with severe pulmonary hypertension (PHT) can be challenging, with a risk of cardiovascular collapse. The administration of ketamine in patients with PHT is controversial, with some recommendations contraindicating its use. However, ketamine has been used safely in children with severe PHT. We present a retrospective case series of adult patients with severe PHT presenting for PTE surgery, using intravenous ketamine as a co-induction anesthetic agent.

Keywords: Cardiac anesthesia; chronic thromboembolic pulmonary hypertension; ketamine; pulmonary hypertension; pulmonary thromboendarterectomy.

MeSH terms

  • Adult
  • Anesthesia*
  • Child
  • Chronic Disease
  • Endarterectomy
  • Humans
  • Hypertension, Pulmonary* / complications
  • Hypertension, Pulmonary* / surgery
  • Ketamine* / therapeutic use
  • Pulmonary Embolism* / complications
  • Pulmonary Embolism* / drug therapy
  • Pulmonary Embolism* / surgery
  • Retrospective Studies

Substances

  • Ketamine