Abstract

ESTRADA KINDELAN, Clara; AMETLER CASTELLANOS, Oneida; MORENO RODRIGUEZ, Nancy  and  CARULLA BALLESTER, Arcilio. Evaluación hemodinámica de la ketamina-morfina para la inducción anestésica en la valvulopatía mitral. Rev Cubana Enfermer [online]. 1999, vol.15, n.2, pp. 109-113. ISSN 1561-2961.

Provincial Hospital "Saturnino Lora" in Santiago de Cuba has been using a combination of narcotics (phentanyl and morphine) with various rapid induction agents as benzodiazepins and barbiturates, but ketamine chlohydrate is a controversial agent so a prospective and descriptive study of 20 patients operated on from june 15th to August 2nd, 1996 in the Cardiovascular Surgery Services of this hospital was presented. The subjects were distributed in two groups: Group I included those affected by mitral stenosis and Group II embraced patients with mitral valve failure and disease, in order to describe surveillance and control of the different clinical indicators by nursing staff. All the patients were provided with the same medication prior to anesthesia and they were prescribed morphine chlohydrate (1 mg) for induction to be intravenously injected for 10 minutes; however, 5 minutes after starting, a bolus of ketamine chlorhydrate (2 mg) was administered for 20-30 seconds. Hemodynamic values of both groups that covered heart rate, blood pressure (systolic, diastolic and medium) and central venous pressure yielded significant statistical differences mainly in group I that was more sensitive as to blood pressure measurements. The ketamine-morphine combination is an interesting technique which has limitations and advantages as well and may be used in some kinds of mitral valve diseases.

Keywords : MITRAL VALV [surgery]; HEMODYNAMICS; KETAMINE [therapeutical use]; MORPHINE [therapeutical use]; CARDIOVASCULAR SURGICAL PROCEDURES [nursery].

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