One hundred and thirty five children have been examined after surgery for congenital heart valve defects performed under ketamine anesthesia. It has been established that ketamine anesthesia has no considerable effect on the preload and cardiac pump function. Different hemodynamic changes have been observed in systemic and pulmonary circulation: the afterload of the left ventricle increases, while the afterload of the right ventricle decreases, which causes an increase in the heart performance (and energy consumption) in the first case and their reduction in the second case. In ketamine anesthesia myocardial contractility is enhanced and relaxation is deteriorated, and the tone of arterial vessels in the kidneys, bulbar conjunctiva, and skeletal muscles is increased. A spasm in the vessels of the conjunctiva is observed even when small drug doses are used. This may be accounted for by calcium accumulation in the muscular cells, noradrenaline hyperproduction, enhanced sensitivity of sympathomimetic receptors to circulating endogenous catecholamines.
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