氯胺酮对硬膜外阻滞病人血流动力学的影响

Hemodynamic Effects of Ketamine on the Patients under Epidural Blockade

观测了氯胺酮对13例硬膜外麻醉病人血流动力学的影响.发现阻滞平面不超过T_4的病人对静注氯胺酮1 mg·kg^(-1)仍表现以心率增速为主的循环兴奋,提示当阻滞不够完善或内脏牵引反应强烈时可以应用小量氯胺酮,改善麻醉效果,减轻病人痛苦.但在使心交感神经完全或几乎完全阻滞的硬膜外麻醉病人,辅用氯胺酮应持慎重态度.

The hemodynamic effects of ketamine on 13 patients under epidural anesthesia were studied. It was found that 1 mg·kg^(-1) of ketamine iv. produced circulatory stimulation manifested mainly by an increase in HR in the epidurally-blocked patients with an analgesic level of T_4 dermatome or less, indicating that ketamine in a dose of 1 mg·kg^(-1) or less can be used to improve epidural anesthesia and make patient comfortable in case that epidural blockade is not complete or visceral traction reaction is obvious. Care, however, should be taken in the patients in whom the cardiosympathetic nerves are blo ked completely or almost completely.