帕金森患者手术前应用氯胺酮的治疗作用  

作　　者：Justin J. Wright Peter D. Goodnight MD, Matthew D. McEvoy, MD 周仁龙(译) 杭燕南(校) 

机构地区：[1]Department of Anesthesiology and Perioperative, Medicine at the Medical University of South Carolina, Charleston, South Carolina [2]不详

出　　处：《麻醉与镇痛》2010年第2期87-89,共3页Anesthesia & Analgesia

摘　　要：黑质多巴胺神经元的减少是帕金森病的典型病理特征，但持续性N-甲基-D-天门冬氨酸受体激活也是一个重要的组成部分。1例进展期帕金森病患者在处理困难气道过程中，静注小剂量氯胺酮（20mg）完全缓解了震颤和发音障碍。这促使了本项病例报道，应用小剂量氯胺酮进行手术前镇静并缓解运动障碍。既往研究和我们的经验均建议根据其效用可给予小剂量氯胺酮，使患者更为舒适，并有利于控制围手术期的帕金森震颤。Loss of dopaminergic neurons from the substantia nigra characterizes the dassical pathology of Parkinson＇s disease, but persistent activation of N-methyl-D-aspartate receptors is also a major component. During difficult airway man- agement in a patient with advanced Parkinson＇s disease, the use of low-dose （20 nag） IV ketamine resulted in complete abolition of severe tremor and dysarthria. This led to the current case report in which low-dose ketamine was used for preoperative sedation and dyskinesia attenuation. Prior research and our experience would suggest that low-dose ketamine, titrated to effect, may provide optimal patient comfort and perioperative control of Parkinsonian tremor.

关 键 词：小剂量氯胺酮 帕金森病 术前应用 治疗作用 患者 N-甲基-D-天门冬氨酸 黑质多巴胺神经元 帕金森震颤 

分 类 号：R719.8[医药卫生—妇产科学]