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氯胺酮、依托咪酯、美索比妥及丙泮尼地的心脏抑制作用。应用收缩期时间间期的临床研究(作者译)

[Cardiodepressive effects due to ketamine, etomidate, methohexitone and propanidid. A clinical study by means of the systolic-time-intervals (author's transl)].

作者信息

Singbartl G, Langrehr D, Neuhaus R

出版信息

Prakt Anaesth. 1976 Dec;11(6):397-404.

PMID:1013052
Abstract

The cardiodepressive effects of ketamine (1mg/kg), etomidate (0.3mg/kg), methohexitone (1mg/kg) and propanidid (4mg/kg) have been compared by means of the systolic time intervals on patients during a steady-state halothane--N2O:02(1.1)-- anaesthesia. This anaesthesia served as a pharmacological model of reduced myocardial function, and moreover, it should block the centrally-elicited cardiac stimulation by ketamine, thus unmasking the direct negative inotropic action of this anaesthetic. Ketamine and etomidate are of lesser cardiac depressant action than methohexitone or even propanidid. Diazepam (0.2-0.25mg/kg) proved to be able to attenuate or abolish, respectively, the ketamine-induced increases of heart rate and blood pressure in normo- and hypertensive patients, and might therefore be useful for induction anaesthesia in cardiac and coronary risk patients, as proved on two patients with recent myocardial infarction.

摘要

通过在患者处于稳态氟烷 - 氧化亚氮 - 氧气(1.1)麻醉期间测量收缩期时间间期,比较了氯胺酮(1mg/kg)、依托咪酯(0.3mg/kg)、美索比妥(1mg/kg)和丙泮尼地(4mg/kg)的心脏抑制作用。这种麻醉作为心肌功能降低的药理学模型,此外,它应能阻断氯胺酮引起的中枢性心脏刺激,从而揭示这种麻醉药直接的负性肌力作用。氯胺酮和依托咪酯的心脏抑制作用比美索比妥甚至丙泮尼地小。地西泮(0.2 - 0.25mg/kg)分别被证明能够减轻或消除正常血压和高血压患者中氯胺酮引起的心率和血压升高,因此可能对心脏和冠状动脉风险患者的诱导麻醉有用,这在两名近期心肌梗死患者身上得到了证实。

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