Actively Recruiting
A Comparison of Ketamine-Lidocaine Versus Ketamine-Fentanyl for Anesthesia Induction Impact on Brain Blood Flow in Patients with Coronary Artery Disease and Left Ventricular Dysfunction Undergoing Elective Coronary Artery Bypass Surgery
Led by Cairo University · Updated on 2026-03-17
40
Participants Needed
1
Research Sites
4 weeks
Total Duration
On this page
AI-Summary
What this Trial Is About
Researchers are comparing two anesthesia induction methods using ketamine combined with either fentanyl or lidocaine to see how they affect brain blood flow in patients with coronary artery disease and significant left ventricular dysfunction undergoing planned coronary artery bypass graft surgery. This study aims to find which induction approach better maintains brain oxygen levels, as no previous data exists on these effects. Participants will receive ketamine slowly until they lose consciousness, followed by either a fentanyl bolus or a lidocaine bolus depending on their group. Afterward, anesthesia will be maintained with isoflurane and oxygen/air, with careful monitoring and treatment for any heart rate or blood pressure changes. Brain oxygen levels will be monitored continuously with near-infrared spectroscopy (NIRS) and other monitoring devices during and after induction. During the study, participants will be assessed for brain oxygenation every few minutes for 20 minutes following anesthesia induction, along with heart rate and blood pressure monitoring. Researchers will also track any episodes of low blood pressure, need for extra fentanyl doses, and postoperative complications such as heart attack, stroke, kidney injury, wound infection, or dialysis within 30 days after surgery. The study will last from December 2025 to July 2026.
CONDITIONS
Brief Title
Ketamine-lidocaine Versus Ketamine-fentanyl for Induction of Anesthesia in Patients With Left Ventricular Systolic Dysfunction Undergoing Elective Coronary Artery Bypass
Who Can Participate
Eligibility Criteria
You may qualify if you...
- Patients with coronary artery disease
- Moderate to severe left ventricular dysfunction with ejection fraction less than 40%
- Scheduled for elective coronary artery bypass graft surgery
- Adults aged 21 years or older
You will not qualify if you...
- History of chronic stroke, transient ischemic attack, or carotid occlusive disease
- Known neurological impairment such as cerebral infarction or dementia
- Significant carotid artery stenosis
- Valvular heart disease
- Persistent arrhythmias
- Congestive cardiac failure
- On mechanical ventilation
- Using intra-aortic balloon pump
- Emergency surgery
- Known allergy to any study drugs
- Severe systemic non-cardiac disease
- Baseline near-infrared spectroscopy (NIRS) reading less than 60%
- Dementia or visual or auditory impairment
AI-Screening
AI-Powered Screening
Complete this quick 3-step screening to check your eligibility
Your Study Journey
Duration - 2 to 4 weeks
Participants are screened for eligibility to participate in the trial.
1 visit (in-person)
Duration - Duration of anesthesia induction and up to 20 minutes afterward
Participants receive anesthesia induction with either ketamine-lidocaine or ketamine-fentanyl before elective coronary artery bypass surgery. Various monitoring procedures including cerebral oximetry and heart rate are performed during and shortly after anesthesia induction.
Continuous monitoring during induction and for 20 minutes post-induction
Duration - 30 days after surgery
Participants are monitored for postoperative complications including myocardial infarction, stroke, acute kidney injury, wound infection, and need for renal replacement therapy for 30 days after extubation.
Follow-up visits or assessments as part of postoperative care
Trial Site Locations
Total: 1 location
1
Kasr Alainy Hospital
Cairo, Egypt, 11562
Actively Recruiting
Research Team
M
Maha Mostafa
How is the study designed?
Study Type
INTERVENTIONAL
Masking
QUADRUPLE
Allocation
RANDOMIZED
Model
PARALLEL
Primary Purpose
PREVENTION
Number of Arms
2
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