Thiopental versus ketamine for induction of anesthesia in septic shock: a randomized controlled trial

Background Induction of anesthesia in patients with septic shock might result in deleterious hypotension. The aim of this work is to compare low-dose thiopental versus ketamine for induction of anesthesia in patients with septic shock.Patients and methods In this randomized controlled double-blinded trial, we included 26 patients with septic shock scheduled for emergency operations under general anesthesia. According to the induction protocol, patients were divided into thiopental group (received thiopental 2 mg/kg+fentanyl 0.5 μg/kg+midazolam 0.05 mg/kg), and ketamine group (received ketamine 1 mg/kg+fentanyl 0.5 μg/kg+midazolam 0.05 mg/kg). Both groups were compared according to mean arterial pressure, cardiac output, heart rate, vasopressor requirements, and incidence of postinduction hypotension.Results Both groups were comparable in demographic data. No significant differences were reported between both groups based on mean arterial pressure, cardiac output, and heart rate; however, ketamine group showed higher incidence of postinduction hypotension [11/13 (85%) vs. 5/13 (39%) patients, P=0.041] compared with thiopental group.Conclusion Both study regimens, thiopental-based regimen and ketamine-based regimen, showed equivalent hemodynamic effects when used for induction of anesthesia in patients with septic shock. However, thiopental-based regimen was less likely associated with postinduction hypotension.