Dick W, Knoche E, Traub E, Milewski P, Specht I
Anaesthesist. 1976 Mar;25(3):83-8.
26 healthy pregnant women at term were divided into 2 groups and anaesthetized with either 1 mg/kh or 2 mg/kg ketamine - N20/02 - for primary caesarean section. Maternal venous ketamine plasma levels, neonatal ketamine plasma levels (umbilical artery and umbilical vein) and blood gases were measured. Maternal venous ketamine plasma levels in group I exceeded those in group II by 2.8 (30-60 sec after injection) and 2.0 (at the time of delivery) respectively. Independent of the dose used, the plasma levels of ketamine in the umbilical artery or the umbilical vein were found to be identical in the two groups of newborn infants. Neonatal blood gases and acid base parameters did not significantly differ between the two groups, except for the oxygen tension in group II which slightly exceeded the PO2 values in group I 15, 60 and 120 min after delivery. pH and standard bicarbonate values were found to be higher (1 and 5 min) in both groups, compared to pH and standard bicarbonate levels in a group of newborns delivered spontaneously.--The results of this study show: 1. Independent of a low or high ketamine dosage, neonatal blood concentration of the drug remain low, probably due to a placental barrier effect.--2. The post partum recovery of the newborns was neither influenced by the ketamine anesthesia itself nor by different drug doses.
26名足月健康孕妇被分为两组,分别以1毫克/千克或2毫克/千克氯胺酮 - N20/02进行麻醉,用于初次剖宫产。测量了母体静脉血中氯胺酮血浆水平、新生儿氯胺酮血浆水平(脐动脉和脐静脉)以及血气。第一组母体静脉血中氯胺酮血浆水平在注射后30 - 60秒和分娩时分别比第二组高出2.8和2.0。两组新生儿中,无论使用何种剂量,脐动脉或脐静脉中的氯胺酮血浆水平均相同。两组新生儿的血气和酸碱参数无显著差异,只是第二组在分娩后15、60和120分钟时的氧分压略高于第一组。与自然分娩的一组新生儿的pH值和标准碳酸氢盐水平相比,两组新生儿在出生后1分钟和5分钟时的pH值和标准碳酸氢盐值更高。——本研究结果表明:1. 无论氯胺酮剂量高低,新生儿药物血药浓度均较低,可能是由于胎盘屏障作用。2. 新生儿产后恢复既不受氯胺酮麻醉本身影响,也不受不同药物剂量影响。