靶控输注低于麻醉剂量氯胺酮的镇痛作用

Analgesic effects of subanesthetic doses of ketamine through target control infusion

目的观察靶控输注低于麻醉剂量的氯胺酮对于健康志愿者的镇痛作用。方法选择13例男性健康志愿者,年龄24-39岁,采用血浆靶控输注的方式给予低于麻醉剂量的氯胺酮,血浆靶浓度分别设定为0,100,200,300ng/ml,每次达到预设靶浓度后稳定10min,进行机械痛评分,整个实验过程中监测并记录志愿者心率、平均动脉压、脉搏血氧饱和度。结果镇痛过程中,氯胺酮产生剂量相关的镇痛作用,血浆靶浓度的增加,机械痛评分下降。当浓度达到200ng/ml时,与不给药时比较机械痛评分明显下降(P<0.05)。镇痛效果与药物浓度呈较好相关性。心率、平均动脉压、脉搏血氧饱和度较用药前无明显变化。结论靶控输注低于麻醉剂量的氯胺酮,当剂量达到200ng/ml时,可出现较明显的镇痛作用。

Objective To explore the analgesic effects of subanesthetic doses of ketamine in healthy volunteers. Methods Thirteen healthy volunteers, aged 24 -39 years ,were enrolled. All subjects received subanesthetic doses of ketamine using target control infusion. A stepwise series of target plasma concentrations ,0,100,200 ,and 300 ng/m] were maintained for 10 min. Visual analogue scale（VAS） was evaluated for mechanical pain. Heart rate, mean blood pressure and SPO2 were monitored throughout the procedure. Results During the process of analgesia, ketamine produced the close-related analgesic effects. When plasma concentrations amounted to 200 ng/ml, VAS decreased significantly compared with that at 0 ng/ml （ P 〈 0.05 ）. Heart rate, mean blood pressure, SPO2 showed no significant changes after giving different concentrations of ketamine. Conclusion Target control infusion of subanesthetic doses of ketamine at 200 ng/ml could produce significant analgesic effects in healthy volunteer.