P325 Effect of low-dose ketamine on immune-inflammatory responses in laparoscopic anti-reflux surgery patients

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Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission Application for ESRA Abstract Prizes Background and Aims Anesthesia and surgery are associated with a weakening of the immune system and addition of anesthetic agents capable of ameliorating changes in immune function perioperative may have a positive effect on patients recovery.Ketamine can have positive effects on the postoperative immune response through a variety of mechanisms,but reports are conflicting.Aim:To investigate the impact of intraoperative subanesthetic doses of Ketamine on postoperative immune-inflammatory responses in laparoscopic anti-reflux surgery patients.Secondary outcome was postoperative pain intensity. Methods In this controlled study,64 adult patients (ASA I–III) scheduled for elective laparoscopic anti-reflux surgery were enrolled.Following induction and intubation, patients in the Ketamine group received a 0.4 mg/kg IV bolus, followed by a 0.25 mg/kg/h infusion continued till the scin was closed.The Control group received saline.Serum levels of CRP, IL-6, and NLR were measured preoperatively and at 24 and 48 hours postoperatively.Pain was assessed using a visual analog scale (VAS) at 1, 6, 12, 24, and 48 hours after surgery. Results Differences of mean values of CRP, IL-6 and NLR between the two groups in the postoperative period were not significant. Serum IL-6 levels 24 h i 48 h after surgery increased lower in Ketamine group, as CRP serum levels at 48 h after surgery, but without statistically significant differences( p=0.946,p=0.984 and p=0.907).However, VAS scores were significantly lower in the Ketamine group at all time points (p<0.001). Conclusions The addition of a low-dose of Ketamine in anti-reflux surgery patients did not exert any evident anti-inflammatory effect in terms of reducing the serum concentrations of inflammatory biomarkers,although leade in reduction of postoperative pain.

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