Helena Ostović

Full Citation: Ostović H, Šimac B, Pražetina M, Bradić N, Peršec J. The Effect of Intravenous Lidocaine, Ketamine, and Lidocaine-Ketamine Combination in Colorectal Cancer Surgery: A Randomized Controlled Trial. Anesth Analg. 2025;140(1):67-76.

I believe that high-quality medical practice requires a complete approach, combining clinical work with a solid understanding of research. Without thorough training in research methodology, an essential part of my clinical development would be missing. I strive to avoid ignorance; continuous learning, familiarity with medical literature and critical appraisal of scientific evidence enable me to evaluate new information and integrate it with my clinical experience. My energy comes from curiosity, the desire for knowledge and the search for meaningful answers.

Helena Ostović, MD, PhD, is an anesthesiologist and intensive care specialist working at University Hospital Dubrava in Zagreb. 

Dr. Ostović graduated from the University of Zagreb School of Medicine in 2008, completed her residency in Anesthesiology, Resuscitation and Intensive Care Medicine in 2015 and became a subspecialist in Intensive Care Medicine in 2019. In 2024, she defended her PhD at the Faculty of Medicine, Josip Juraj Strossmayer University of Osijek.

Her clinical work focuses on perioperative and intensive care of high-risk surgical patients, while her scientific interests lie at the intersection of anesthetic techniques, pain management, inflammation and postoperative recovery. Through her research, she aims to improve patient outcomes using safe, effective and widely applicable anesthetic strategies.

Optimizing opioid-sparing anesthesia in colorectal cancer surgery

Dr. Ostović’s research addresses a major challenge in colorectal cancer surgery, which is associated with a pronounced inflammatory response, severe postoperative pain and postoperative ileus. In recent years, anesthesiology practice has increasingly shifted toward multimodal, opioid-sparing and opioid-free anesthesia to reduce opioid-related adverse effects and support enhanced recovery.

In this randomized, double-blind, placebo-controlled trial with a 2 × 2 factorial design, the study evaluated whether intravenous lidocaine, ketamine or their combination – administered as a preincisional bolus followed by intraoperative infusion – could attenuate postoperative inflammatory response and improve clinical outcomes in patients undergoing open colorectal cancer resection.

The results demonstrated that intraoperative administration of lidocaine and/or ketamine did not significantly reduce inflammatory marker concentrations nor influence gastrointestinal motility. However, both agents proved to be safe and effective adjuvants, reducing intraoperative opioid requirements and, except for lidocaine alone, improving postoperative pain scores. Importantly, this was the first study to evaluate the combined effects of lidocaine and ketamine in colorectal surgery.

The clinical relevance of this work is significant, as lidocaine and ketamine are conventional, inexpensive and widely available anesthetic agents. The findings support their use as part of multimodal, opioid-sparing anesthesia protocols, contributing to safer pain management and improved perioperative care without compromising immune or inflammatory outcomes.

Compassion, Curiosity and Creativity in Medicine

Dr. Ostović chose medicine out of a deep empathy for people who are vulnerable or suffering, combined with a strong interest in human anatomy, physiology and chemistry. She was drawn to anesthesiology and intensive care because of the complexity of caring for critically ill patients, the use of advanced manual skills and the opportunity to perform work that is often discreet yet profoundly impactful.

Her motivation for research stems from a genuine love for her profession and the belief that high-quality clinical practice must be grounded in a solid understanding of scientific evidence. She values continuous learning, critical appraisal of medical literature and integrating research insights into everyday clinical decision-making. Curiosity and the search for meaningful answers remain her primary sources of energy.

Outside of medicine, she finds balance and inspiration in painting, which teaches patience, discipline and deep observation. She also enjoys recreational sports, reading, classic films and series and traveling. These pursuits provide a creative counterbalance to her medical work and support her lifelong development.

Being selected as a finalist for the International Medis Awards represents a great personal honor and a strong motivation for continued growth. For Dr. Ostović, it is a recognition of perseverance, consistent effort and commitment to excellence in both clinical and scientific work and an encouragement to continue along a demanding but deeply meaningful professional path.