Lahrmann Karl-Heinz, Baars Jan, Rintisch Ulf
Klinik für Klauentiere, Freie Universität Berlin.
Klinik für Anästhesiologie und operative Intensivmedizin, Charité-Universitätsmedizin Berlin.
Berl Munch Tierarztl Wochenschr. 2014 Jan-Feb;127(1-2):3-11.
was observed. Perioperatively oxygen saturation was persistently high and mean arterial pressure was steady, too. An additional Ketamine administration caused a short tachycardia during operation. After restoration of total mobility, respiratory and heart rate stayed within the reference ranges again. All EMG values in between those caused by pain stimuli were significantly below the borderline of a muscle activity in conformity with a clinically visible complete muscle relaxation. Cortisol increased simultaneously with Ketamine and Azaperone before operation, but it remained at this level until the end of the determinations, parallel to the course of Norketamine, close to the maximum before anesthesia. The complex intensive-medical monitoring confirms that under real surgical conditions the counter-regulatory effects of both drugs equalize the respective cardiovascular and respiratory side effects. It is concluded also that the increase of cortisol is likely to be more a side effect of Ketamine/Norketamine than the expression of distress by surgical interventions or by wake-up reactions, and that an intoxication by additional Ketamine dosage or motoric disorders (i.e., catalepsis) can be excluded as undesired side effects of both drugs.
观察到。围手术期氧饱和度持续偏高，平均动脉压也保持稳定。额外给予氯胺酮导致术中出现短暂心动过速。恢复完全活动能力后，呼吸和心率再次保持在参考范围内。在疼痛刺激引起的肌电图值之间，所有值均显著低于肌肉活动的临界值，符合临床上可见的完全肌肉松弛。皮质醇在术前与氯胺酮和阿扎哌隆同时升高，但在测定结束前一直保持在该水平，与去甲氯胺酮的变化过程平行，接近麻醉前的最大值。复杂的重症监护证实，在实际手术条件下，两种药物的反调节作用可平衡各自的心血管和呼吸副作用。还得出结论，皮质醇升高可能更多是氯胺酮/去甲氯胺酮的副作用，而非手术干预或苏醒反应引起的应激表现，并且可以排除额外氯胺酮剂量中毒或运动障碍（即僵住症）作为两种药物的不良副作用。
