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氯胺酮麻醉期间的氧摄取与中枢循环

Oxygen uptake and central circulation during ketamine anaesthesia.

作者信息

Tokics L, Brismar B, Hedenstierna G, Lundh R

出版信息

Acta Anaesthesiol Scand. 1983 Aug;27(4):318-22. doi: 10.1111/j.1399-6576.1983.tb01959.x.

Abstract

Cardiac output, oxygen uptake and plasma catecholamines were studied in patients when awake and during ketamine anaesthesia prior to and during upper abdominal surgery. Oxygen uptake was determined by using a masspectrometer and cardiac output was measured according to the Fick principle. Plasma catecholamines were analysed by high performance liquid chromatography. Stroke volume had fallen by 27% while heart rate had increased after 15 min of anaesthesia, maintaining cardiac output at the awake level. Concomitantly, the oxygen uptake had fallen by 18%. During the succeeding hour of anaesthesia and surgery, cardiac output displayed a transient decrease and oxygen uptake returned to the awake value. The plasma adrenaline concentration fell during the initial phase of anaesthesia and then returned to the awake level. The noradrenaline concentration was increased during the whole anesthetic period. The data suggest a relationship between oxygen uptake and cardiac output during ketamine anaesthesia, similar to that seen during neurolept-nitrous oxide and halothane anaesthesia, except for the initial hyperkinetic period following the induction. No relationship could be shown between catecholamine concentrations in plasma and the central haemodynamics.

摘要

在清醒状态以及上腹部手术前和手术期间氯胺酮麻醉时,对患者的心输出量、氧摄取和血浆儿茶酚胺进行了研究。氧摄取通过质谱仪测定,心输出量根据菲克原理测量。血浆儿茶酚胺通过高效液相色谱法分析。麻醉15分钟后,每搏量下降了27%,而心率增加,使心输出量维持在清醒水平。与此同时,氧摄取下降了18%。在随后的麻醉和手术的一小时内,心输出量出现短暂下降,氧摄取恢复到清醒时的值。血浆肾上腺素浓度在麻醉初期下降,然后恢复到清醒水平。去甲肾上腺素浓度在整个麻醉期间都升高。数据表明,氯胺酮麻醉期间氧摄取和心输出量之间存在关系,类似于在神经安定-氧化亚氮和氟烷麻醉期间观察到的关系,但诱导后最初的高动力期除外。血浆中儿茶酚胺浓度与中心血流动力学之间未显示出相关性。

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