AT A GLANCE

A new study published in Medicine (Baltimore) found no obvious superiority in the effects of ketamine versus dexmedetomidine (Dex) after liver resection.¹

“Studies have demonstrated the potent anti-inflammatory and analgesic effects of [ketamine and Dex] on an individual basis. There are therefore strong indications that giving Dex plus ketamine to patients undergoing liver resection surgery may reduce post-procedural inflammation and pain,” explain study authors Ates et al. “The aim of this study was to evaluate and compare the effects of ketamine and Dex on inflammation and postoperative pain in liver resection surgery.”

For study purposes, a total of 45 American Society of Anesthesiologists class III patients scheduled for liver resection surgery were randomized into three equal groups according to treatment received. Patients in ketamine group received an intravenous ketamine bolus (0.5 mg/kg) during anesthesia induction and continuous low-dose infusion at 0.25 mg/kg/h thereafter; patients in the Dex group received an intravenous infusion initiated at a 1-µg/kg bolus for the first 10 min, then at 0.5 µg/kg/h after intubation; and patients in the control group were infused with a crystalloid solution at 8 mL/kg/h from induction onward. Venous blood was collected at 1 and 12 h postoperatively for the measurement of pentraxin 3, serum amyloid A, hepcidin, and inflammatory markers, and visual analog scale (VAS) scores were recorded.

According to the authors, as of 12 h postoperatively, levels of pentraxin 3, serum amyloid A, and hepcidin continued to rise in the control group but began declining in the Dex and ketamine infusion groups, respectively. Along similar lines, VAS scores and fentanyl consumption decreased in the ketamine and Dex groups compared to in the control group, with the reductions in inflammatory parameters, VAS scores, and fentanyl consumption being similar between the ketamine and Dex groups.

The authors also observed a positive correlation between inflammation levels and pain severity, while no difference was found in liver function test results between any of the groups.

“Ketamine and Dex infusions were both effective in reducing inflammation and pain following liver resection, with no obvious superiority of one over the other,” conclude the authors.

Reference

1.     Ates İ, Laloglu E, Kara S, Yaman T, Isik B. The effects of dexmedetomidine and ketamine infusions on the inflammatory response in liver resection: A randomized double-blind placebo study. Medicine (Baltimore). 2025;104(27):e42999.