Min S K, Lee S Y, Park K S, Yoo J, Chae Y J
Department of Anaesthesiology and Pain Medicine, Ajou University School of Medicine, Suwon, Republic of Korea.
J Int Med Res. 2011;39(4):1408-12. doi: 10.1177/147323001103900427.
The bolus effective dose of ketamine required to prevent withdrawal movement on injection of rocuronium was determined in 27 paediatric patients undergoing elective surgery. A predetermined dose of ketamine was given intravenously on arrival in the operating room and anaesthesia (2.5% thiopental, 5 mg/kg) was administered 1 min later. After loss of consciousness, 1% rocuronium at 0.6 mg/kg was injected over 5 s and the presence or absence of withdrawal movement recorded. The effective dose of ketamine was determined using a modified Dixon up-and-down method with a step size of 0.1 mg/kg, successful prevention of withdrawal movement being defined as no response or movement at the wrist only. The bolus effective dose of ketamine for preventing withdrawal movement after injection of rocuronium following thiopental anaesthesia in 50% of paediatric patients (ED(50)) was 0.21 mg/kg according to the modified Dixon up-and-down method. Probit analysis indicated an ED(50) of 0.18 mg/kg and an ED(95) of 0.33 mg/kg. The latter was the most satisfactory dose in the clinical setting.
在27例接受择期手术的儿科患者中，测定了预防注射罗库溴铵时出现退缩动作所需的氯胺酮单次有效剂量。患者到达手术室后静脉给予预先确定剂量的氯胺酮，1分钟后给予麻醉（2.5%硫喷妥钠，5mg/kg）。意识消失后，在5秒内注射0.6mg/kg的1%罗库溴铵，并记录是否存在退缩动作。采用改良的Dixon上下法，步长为0.1mg/kg，测定氯胺酮的有效剂量，成功预防退缩动作定义为无反应或仅手腕部有动作。根据改良的Dixon上下法，硫喷妥钠麻醉后50%的儿科患者（ED(50)）预防注射罗库溴铵后出现退缩动作所需的氯胺酮单次有效剂量为0.21mg/kg。概率分析表明ED(50)为0.18mg/kg，ED(95)为0.33mg/kg。后者是临床环境中最满意的剂量。
