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[地西泮对持续静脉滴注氯胺酮的心血管及拟精神病作用的影响。双盲研究(作者译)]

[Effect of diazepam on cardio-vascular and psychotomimetic action of ketamine administered as continuous intravenous drip. Double-blind study (author's transl)].

作者信息

Pedersen T, Hicquet J

出版信息

Anesth Analg (Paris). 1981;38(7-8):321-5.

PMID:7305036
Abstract

Sixty-four women undergoing non-abdominal operations were anaesthetized with ketamine administered as a continuous intravenous drip combined or not with diazepam. This double-blind, randomised study assessed the effects of diazepam on the dosage, the cardio-vascular stimulation, and the psychotomimetic side-effects of ketamine. At the induction, ketamine was given in a dose of 2 mg/kg in combination with diazepam 10 mg or placebo i.v. followed by a continuous infusion of ketamine at variable rate. The amounts of ketamine necessary for anaesthesia was significantly reduced by diazepam, from 4.51 mg/kg to 3.55 mg/kg (p less than 0.001). The sympathomimetic effect of ketamine was significantly decreased by diazepam, as the increase in pulse rate as well as in blood pressure was less important (p less than 0.05). The frequency of hallucinations dropped from 30.0 p. cent to 2.9 p. cent with diazepam, while the total frequency of psychotomimetic side-effects fell from 36.6 p. cent to 11.8 p. cent (p less than 0.05). Although the frequency of psychotomimetic side-effects is still high with this method, it may be recommended to use a continuous drip of ketamine administration for anaesthesia of hypovolaemic and other poor risk patients.

摘要

64名接受非腹部手术的女性患者,通过静脉持续滴注氯胺酮进行麻醉,同时或不同时使用地西泮。这项双盲随机研究评估了地西泮对氯胺酮剂量、心血管刺激及拟精神副作用的影响。诱导期,氯胺酮以2mg/kg的剂量与10mg地西泮或安慰剂静脉注射联合使用,随后以可变速率持续输注氯胺酮。地西泮显著降低了麻醉所需氯胺酮的量,从4.51mg/kg降至3.55mg/kg(p<0.001)。地西泮显著降低了氯胺酮的拟交感神经作用,因为心率和血压的升高不太明显(p<0.05)。使用地西泮时,幻觉发生率从30.0%降至2.9%,而拟精神副作用的总发生率从36.6%降至11.8%(p<0.05)。尽管这种方法的拟精神副作用发生率仍然很高,但对于低血容量及其他高危患者的麻醉,建议采用氯胺酮持续滴注给药。

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