【摘要】 目的:研究氯胺酮对丙泊酚静脉麻醉后药动学、药效学的影响。方法:24例门诊无痛人流术患者随机分为2.5mg·kg-1丙泊酚静脉麻醉组(A组,n=8)、复合0.25mg·kg-1氯胺酮组(B组,n=8)及复合0.75mg·kg-1氯胺酮组(C组,n=8)。分别在停止注射丙泊酚后0、2、4、6、8、10、15、30、45min与1、2、3h及唤醒、清醒时采集未注药侧肘静脉血,用高效液相色谱法测定单次给药后各时点丙泊酚血药浓度,并由3p97软件处理计算出药动学参数,同时监测相应时间点收缩压(SBP)、舒张压(DBP)、心率(HR)、血氧饱和度(SpO2)。结果:与A组比较,B、C组的t1/2α、Vd呈减少趋势(A、C组比较:P<0.05);B、C组的K12、CL呈增加趋势(A、C组比较:P<0.05)。3组间t1/2β、K21、K10差异无统计学意义。停止注射丙泊酚后1～4min血压、HR、SpO2变化明显,SBP、DBPA、C组比较:P<0.05或B、C组比较:P<0.05;HRA、C组比较:P<0.05;SpO2A、C组比较:P<0.05。结论:单次静脉注射氯胺酮0.75mg·kg-1可促进丙泊酚的分布或再分布,而氯胺酮0.25mg·kg-1对丙泊酚分布或再分布无明显影响。2.5mg·kg-1丙泊酚复合0.25mg·kg-1氯胺酮用于无痛人流术安全、有效。更多还原

【Abstract】 OBJECTIVE:To study the effects of ketamine on pharmacokinetics and pharmacodynamics of propofol. METHODS:24 outpatients undergoing painless abortion were randomly assigned into group A(2.5 mg·kg-1propofol via i.v.,n=8), group B(propofol combined with 0.25 mg·kg-1 ketamine,n=8)and groups C(propofol combined with 0.75 mg·kg-1 ketamine, n=8). Blood samples were taken from basilical vein or brachial veins at 0 min,2 min,4 min,6 min,8 min,10 min,15 min, 30 min,45 min,1 h,2 h,3 h after medication,and at wake-up time and sober moments. Plasma concentrations of propofol were measured by HPLC and pharmacokinetic parameters were calculated using 3p97 software. SBP,DBP,HR and SpO2 were detected. RESULTS:Compared with group A,t1/2α and Vd in group B and group C decreased(group A vs. group C,P<0.05). K12 and CL in group B and group C increased(group A vs. group C,P<0.05). There was no statistical significance in difference of t1/2β,K21, K10 among three groups. SBP,DBP,HR and SPO2 were obviously differences at 1～4 min after injection. SBP and DBP in group C were higher than in group A and group B(P<0.05 or P<0.05);HR in group C was significantly higher than in group A(P< 0.05);SpO2 in group C was distinctly lower than in group A(P<0.05). CONCLUSION:Single dose of 0.75 mg·kg-1 ketamine may promote propofol distribution or redistribution while 0.25 mg·kg-1 ketamine has no significant effects on it. Propofol(2.5 mg· kg-1)combined with ketmine(0.25 mg·kg-1)is safe and effective for painless abortion.更多还原