Morse Zac, Sano Kimito, Kanri Tomio
School of Oral Health, Fiji School of Medicine.
Pac Health Dialog. 2003 Mar;10(1):51-4.
As the ideal sedative does not exist for all situations, particularly in settings with limited resources, the effect of a propofol-ketamine combination in human volunteers was examined. Eleven American Society of Anesthesiologists (ASA) physical status I volunteers were administered propofol at a loading dose of 1 mg/kg and two minutes later by 0.7 mg/kg of ketamine. This was followed by a propofol-ketamine combination of 5 mg/kg of propofol admixed with 0.7 mg/kg of ketamine that was infused over one hour via a 60 gtts/ml intravenous. Infusion set. Cardiorespiratory parameters were recorded and blood samples taken to measure plasma catecholamine levels prior to, during and for thirty minutes following the termination of the infusion. Rate of respiration and oxygen saturation levels did not alter significantly from baseline levels. When there was a cardiovascular decrease from base line levels it was on average 11% for systolic, 15% diastolic blood pressure and 14% for heart rate. Only plasma adrenaline and noradrenaline increased by 28 and 20%, 10 minutes following the bolus injectons. No dysphoria was experienced. This combined sedoanalgesic technique in nonstimulated human volunteers maintains spontaneous ventilation and may be considered as abalanced alternative to traditional conscious sedation or general anesthesia.
由于不存在适用于所有情况的理想镇静剂,尤其是在资源有限的环境中,因此研究了丙泊酚 - 氯胺酮组合对人类志愿者的影响。11名美国麻醉医师协会(ASA)身体状况为I级的志愿者先接受1mg/kg负荷剂量的丙泊酚,两分钟后再给予0.7mg/kg氯胺酮。随后通过60滴/毫升的静脉输液器在一小时内输注5mg/kg丙泊酚与0.7mg/kg氯胺酮混合的丙泊酚 - 氯胺酮组合。记录心肺参数,并在输注前、输注期间和输注结束后30分钟采集血样以测量血浆儿茶酚胺水平。呼吸频率和血氧饱和度水平与基线水平相比无显著变化。当心血管指标从基线水平下降时,收缩压平均下降11%,舒张压下降15%,心率下降14%。推注后仅10分钟,血浆肾上腺素和去甲肾上腺素分别增加28%和20%。未出现烦躁不安。这种在未受刺激的人类志愿者中联合使用的镇静镇痛技术可维持自主通气,可被视为传统清醒镇静或全身麻醉的一种平衡替代方法。