Effects of Dexmedetomidine Versus Ketamine on Inflammatory Response and Hemodynamic in Patients

Inclusion Criteria: * • Adult patients admitted to ICU after ileus surgery (perforated viscus, infarcted bowel, strangulated hernia, anastomotic leakage, diverticulitis, and intestinal obstruction), and who will be expected to require postoperative sedation and ventilation. * Abdominal sepsis was determined as organ dysfunction with a substantial change in overall SOFA score (2) ≥ 2 points because of intra-abdominal sepsis. Exclusion Criteria: * • Known allergy to ketamine, dexmedetomidine, * Confirmed pregnancy, * Heart failure (class 3 or 4 of the New York Heart Association), * Renal failure (RIFLE classification), * Liver failure (manifested by serum total protein concentration \<3 g/dl and total bilirubin \>5 mg/dl) * Known or suspected brain death. * Patients who receive neuromuscular blockers during the first 48 hours of ICU admission will also be excluded.