Effet immunomodulateur de la kétamine lors d’une chirurgie de cancer colorectal: une étude randomisée contrôlée

Translated title of the contribution: The immunomodulatory effect of ketamine in colorectal cancer surgery: a randomized-controlled trial

Jin Sun Cho, Na Young Kim, Jae Kwang Shim, Ji Hae Jun, Sugeun Lee, Young Lan Kwak

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: Ketamine’s inhibitory action on the N-methyl-d-aspartate receptor and anti-inflammatory effects may provide beneficial immunomodulation in cancer surgery. We investigated the effect of subanesthetic-dose ketamine as an adjunct to desflurane anesthesia on natural killer (NK) cell activity and inflammation in patients undergoing colorectal cancer surgery. Methods: A total of 100 patients were randomly assigned to a control or ketamine group. The ketamine group received a bolus of 0.25 mg·kg−1 ketamine five minutes before the start of surgery, followed by an infusion 0.05 mg·kg−1·hr−1 until the end of surgery; the control group received a similar amount of normal saline. We measured NK cell activity and proinflammatory cytokines (interleukin-6 [IL-6] and tumour necrosis factor-α [TNF-α]) before surgery and one, 24, and 48 hr after surgery. C-reactive protein (CRP) was measured before surgery and one, three, and five days after surgery. Carcinoembryonic antigen and cancer recurrence/metastasis were assessed two years after surgery. Results: The NK cell activity was significantly decreased after surgery in both groups, but the change was not different between groups in the linear mixed model analysis (P = 0.47). Changes in IL-6, TNF-α, CRP, and carcinoembryonic antigen levels were not different between groups (P = 0.27, 0.69, 0.99, and 0.97, respectively). Cancer recurrence within 2 years after surgery was similar between groups (10% vs 8%, P = 0.62). Conclusions: Intraoperative low-dose ketamine administration did not convey any favourable impacts on overall postoperative NK cell activity, inflammatory responses, and prognosis in colorectal cancer surgery patients. Trial registration: www.clinicaltrial.gov (NCT03273231); registered 6 September 2017.

Translated title of the contributionThe immunomodulatory effect of ketamine in colorectal cancer surgery: a randomized-controlled trial
Original languageFrench
JournalCanadian Journal of Anesthesia
DOIs
Publication statusAccepted/In press - 2021

Bibliographical note

Funding Information:
This work was supported by the National Research Foundation of Korea (NRF) grant funded by the Korea government (No. 2017R1C1B5018102).

Publisher Copyright:
© 2021, Canadian Anesthesiologists' Society.

All Science Journal Classification (ASJC) codes

  • Anesthesiology and Pain Medicine

Fingerprint Dive into the research topics of 'The immunomodulatory effect of ketamine in colorectal cancer surgery: a randomized-controlled trial'. Together they form a unique fingerprint.

Cite this