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低剂量氯胺酮麻醉期间脑电活动和颅内血流速度同时增加。

Concurrent increases in brain electrical activity and intracranial blood flow velocity during low-dose ketamine anaesthesia.

作者信息

Kochs E, Werner C, Hoffman W E, Möllenberg O, Schulte am Esch J

机构信息

Department of Anaesthesiology, University Hospital Eppendorf, Hamburg, Germany.

出版信息

Can J Anaesth. 1991 Oct;38(7):826-30. doi: 10.1007/BF03036955.

Abstract

The purpose of the present study was to assess the effects of low-dose ketamine on spontaneous brain electrical activity (EEG) and intracranial blood flow velocity. Twenty healthy volunteers were divided into two groups: Group I (n = 10) received 0.25 mg.kg-1 ketamine iv; Group II (n = 10) received 0.5 mg.kg-1 ketamine iv. Mean arterial blood pressure (MAP), heart rate (HR), end-tidal PCO2 (PETCO2), and arterial oxygen saturation (SaO2) were measured. The EEG was recorded from temporo-occipital recording sites over both hemispheres. Blood flow velocity in the middle cerebral artery was measured using a transcranial Doppler ultrasound system. All variables were evaluated at baseline and for 60 min following ketamine. Administration of ketamine resulted in increases of MAP and HR in both groups to a similar degree. The PETCO2 and SaO2 did not change in either group over time. Ketamine caused a dose-dependent, transient shift in the EEG to synchronous high-voltage slow waves with an increase in total power (Group I: 301 +/- 38%; Group II: 104 +/- 28%). These changes were associated with dose-dependent increases in mean blood flow velocity (Group I: 35 +/- 7%; Group II: 68 +/- 10%). Our data suggest that increases in intracranial blood flow velocity are closely correlated to increases in neuronal activity and are not secondary to changes in systemic haemodynamic variables.

摘要

本研究的目的是评估低剂量氯胺酮对自发性脑电活动(脑电图)和颅内血流速度的影响。20名健康志愿者被分为两组:第一组(n = 10)静脉注射0.25 mg.kg-1氯胺酮;第二组(n = 10)静脉注射0.5 mg.kg-1氯胺酮。测量平均动脉血压(MAP)、心率(HR)、呼气末二氧化碳分压(PETCO2)和动脉血氧饱和度(SaO2)。脑电图记录来自双侧颞枕记录部位。使用经颅多普勒超声系统测量大脑中动脉的血流速度。所有变量在基线时以及氯胺酮给药后60分钟进行评估。氯胺酮给药导致两组的MAP和HR均有相似程度的升高。两组的PETCO2和SaO2随时间均未改变。氯胺酮导致脑电图出现剂量依赖性的短暂转变,变为同步高压慢波,总功率增加(第一组:301±38%;第二组:104±28%)。这些变化与平均血流速度的剂量依赖性增加相关(第一组:35±7%;第二组:68±10%)。我们的数据表明,颅内血流速度的增加与神经元活动的增加密切相关,并非继发于全身血流动力学变量的变化。

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