单剂氯胺酮抗抑郁治疗对心率、血压和血氧饱和度的影响

Effects of single i.v. subanesthetic dose of ketamine on heart rate,blood pressure and oxygen saturation for antidepressant treatment

目的探讨单次亚麻醉剂量氯胺酮静脉点滴抗抑郁治疗对重性抑郁障碍患者心率、血压、血氧饱和度的影响。方法重性抑郁障碍患者随机分为氯胺酮组(13例)和对照组(14例),分别接受氯胺酮(0.5 mg/kg)单次注射治疗和生理盐水单次注射,并口服4周艾司西酞普兰片(10 mg/d)。比较两组基线、注射后40 min、100 min和280 min时点心率、血压、血氧饱和度。结果心率、收缩压和舒张压均为时间主效应有统计学意义(P<0.05),组别主效应无统计学意义(P>0.05),时间×组别交互作用有统计学意义(P<0.05)。心率、收缩压和舒张压40 min时点高于其它时点(P<0.05),其它时点间无统计学差异(P>0.05)。两组血氧饱和度时间主效应、组别主效应、时间×组别交互效应均无统计学意义(P>0.05)。结论单次亚麻醉剂量氯胺酮静脉点滴抗抑郁治疗可能引起一过性心率和血压增加。

Objective To investigate the effects of single i.v. subanesthetic dose of ketamine on heart rate, blood pressure and oxygen saturation for antidepressant treatment. Methods Patients with severe depressive disorder were randomized to ketamine group (n=13) and control group (n=14). Ketamine group received ketamine (0.5mg/kg) single injection whereas control group received saline single injection. Escitalopram (10 mg/d) were orally administered for 4 weeks simultaneously. Comparisons were made on the heart rate, blood pressure and oxygen saturation at baseline, 40 min, 100 min, and 280 min after injection between the two groups. Results The main effects of time but not group were significant for all parameters including heart rate, systolic blood pressure and diastolic blood pressure,(P<0.05). Interaction of time×group was significant (P<0.05). All parameters including heart rate (F=16.85, P<0.01), systolic blood pressure (F=15.82, P<0.01) and diastolic blood pressure (F=8.63, P<0.01) with time were significant in ketamine group. The heart rate, systolic blood pressure and diastolic blood pressure in ketamine group were significantly higher at 40 min than at other time points (P<0.05), while were no significant difference among other time points (P>0.05). There was no statistical significance of main effect of time, group and interaction of time×group in oxygen saturation between the two groups (P>0.05). Conclusion Single subanesthetic dose ketamine intravenous drip for antidepressant therapy may cause a transient increase in heart rate and blood pressure.