氯胺酮对大面积烧伤病人全身氧供求平衡的影响

Effects of Ketamine on Oxygen Supply-Demand Balance in Severely Burned Patients

通过对１０例５３．７％ＴＢＳＡ烧伤病人应用氯胺酮后心脏指数、呼吸、血气分析和生化等指标变化的观察，发现处于高代谢高血流动力学状态的大面积烧伤病人使用氯胺酮后，仍有肾上腺素释放量的进一步增加，从而增加心输出量和组织灌流。呼吸储备未见不良影响，亦未见组织缺氧和耗氧加重，全身氧供求关系仍可保持平衡。

he effects of ketamine anesthesia on oxygen supply-demand balance were studied in ten hypermetabolic-hy-perhemodynamic burned patients undergoing debridement and skin-grafting procedures. Mean burn size was 53.7±14%TBSA. Anesthesia was induced with ketamine 2 mg/kg and maintained by an infusion of ketamine,50μg/kg/min, The results show that ketamine could further increase plasma level of catecholamines resulting in the increasein cardiac output and tissue perfusion. The gradual decrease of plasma concentration of hypoxanthine suggests thattissue oxygen supply remained unchanged. It is thus concluded that in severely burned patients low dose of ke-tamine anesthesia can maintain an adequate oxygen supply-demand balance.