Tosh Pulak, Rajan Sunil, Puthenveettil Nitu, Kumar Lakshmi
Department of Anaesthesiology, Amrita Institute of Medical Sciences, Amrita University, Kochi, Kerala, India.
Anesth Essays Res. 2017 Jul-Sep;11(3):617-620. doi: 10.4103/aer.AER_36_17.
The most commonly used drug for total intravenous anesthesia (TIVA) is ketamine which results in cardiovascular stimulation.
The primary aim of this study was to assess the effect of oral clonidine premedication on attenuating the hemodynamic responses following ketamine administration.
This was a prospective, observational, comparative study conducted in a tertiary care institution.
A total of 40 female patients aged 18-55 years who were posted for elective short gynecological procedures under TIVA were recruited for this study. Group A patients were given oral clonidine 150 μg 60 min before proposed surgical procedure, whereas Group B patients received a placebo tablet. Before induction, all patients received glycopyrrolate 0.2 mg, midazolam 2 mg, and fentanyl 2 μg/kg intravenously. Anesthesia was induced with ketamine 1.5 mg/kg body weight intravenously over 2-3 min. The hemodynamics after premedication and induction were assessed.
To test the statistical significance or difference between the mean change from the basal value at various time points, student's -test was applied.
At 20, 30, 40, 50, and 60 min postpremedication and after induction at 1, 3, 5, 10, 15, 20, and 30 min, Group B showed significantly higher heart rate. Systolic and diastolic blood pressures showed a significant decrease in Group A after induction up to 30 min. Nearly 6.7% of the patients in Group B had emergence delirium with none in Group A, which was not statistically significant.
Oral premedication with clonidine 150 μg, administered 60 min before the conduct of TIVA, attenuated hemodynamic responses of intravenous ketamine.
全凭静脉麻醉（TIVA）最常用的药物是氯胺酮，它会引起心血管刺激。
本研究的主要目的是评估口服可乐定预处理对减轻氯胺酮给药后血流动力学反应的影响。
这是一项在三级医疗机构进行的前瞻性、观察性、对比研究。
本研究共招募了40名年龄在18 - 55岁、计划在TIVA下进行择期简短妇科手术的女性患者。A组患者在拟行手术前60分钟口服150μg可乐定，而B组患者服用安慰剂片。诱导前，所有患者静脉注射0.2mg格隆溴铵、2mg咪达唑仑和2μg/kg芬太尼。静脉注射1.5mg/kg体重的氯胺酮，在2 - 3分钟内诱导麻醉。评估预处理和诱导后的血流动力学。
为检验各时间点相对于基础值的平均变化之间的统计学显著性或差异，应用了学生t检验。
预处理后20、30、40、50和60分钟以及诱导后1、3、5、10、15、20和30分钟，B组心率显著更高。诱导后直至30分钟，A组收缩压和舒张压显著下降。B组近6.7%的患者出现苏醒期谵妄，A组无此情况，差异无统计学意义。
在进行TIVA前60分钟口服150μg可乐定预处理可减轻静脉注射氯胺酮的血流动力学反应。
