[预防与低剂量连续静脉输注氯胺酮相关的精神副作用]
[Prevention of psychedelic side effects associated with low dose continuous intravenous ketamine infusion].
作者信息
Remerand Francis, Couvret Claude, Pourrat Xavier, Le Tendre Charlotte, Baud Annick, Fusciardi Jacques
机构信息
Groupement d'Anesthésie Réanimation, Hôpital Trousseau, CHU de Tours, Tours, France.
出版信息
Therapie. 2007 Nov-Dec;62(6):499-505. doi: 10.2515/therapie:200802. Epub 2008 Mar 4.
OBJECTIVE
Continuous low dose infusion of intravenous ketamine for postoperative analgesia was often associated with frightening acute psychodysleptic experiences in our patients. We hypothesized they were due to boluses of ketamine accumulated in the infusion line. We evaluated on two successive groups the impact of perfusion line modifications on psychodysleptic side effects occurrence.
METHODS
We compared a reference historic group (in which ketamine line was connected to perfusion line) to a second prospective group (in which ketamine line was connected to the venous catheter via an unidirectional valve).
RESULTS
Psychodysleptic experiences occurrence decreased from 4 patients of 26 (15%) to 2 of 116 (2%, p = 0.01). Moreover, these experiences were no longer associated with severe anxious symptoms like near death experiences.
CONCLUSION
An unidirectional valve must be considered to limit the occurrence of low dose intravenous ketamine infusion associated psychedelic side effects, during postoperative analgesia.
目的
在我们的患者中，持续低剂量静脉输注氯胺酮用于术后镇痛常伴有令人恐惧的急性精神错乱体验。我们推测这是由于氯胺酮在输液管路中蓄积所致。我们在连续两组患者中评估了输液管路改良对精神错乱副作用发生情况的影响。
方法
我们将一个参考历史组（氯胺酮管路连接到输液管路上）与第二个前瞻性组（氯胺酮管路通过单向阀连接到静脉导管上）进行了比较。
结果
精神错乱体验的发生率从26例中的4例（15%）降至116例中的2例（2%，p = 0.01）。此外，这些体验不再与濒死体验等严重焦虑症状相关。
结论
在术后镇痛期间，必须考虑使用单向阀来限制低剂量静脉输注氯胺酮相关的迷幻副作用的发生。
Zotero 插件