全身麻醉诱导时咪唑安定与氯胺酮催眠相互作用的研究  

Hypnotic interaction between midazolam and ketamine during induction of general anesthesia

作　　者：陈鸿[1] 潘宁玲[1] 

机构地区：[1]北京军区总医院麻醉科,100700

出　　处：《临床麻醉学杂志》2010年第10期851-853,共3页Journal of Clinical Anesthesiology

摘　　要：目的以等辐射分析法研究全身麻醉诱导时咪唑安定与氯胺酮之间催眠相互作用。方法将90例择期上腹部手术患者随机分为:咪唑安定组(M组)、氯胺酮组(K组)、咪唑安定与氯胺酮复合组(C组),每组30例。麻醉诱导前各组以序贯方式给予不同剂量的咪唑安定、氯胺酮及两药复合药物(咪唑安定与氯胺酮剂量的数值比为1∶10),给药2min后开始催眠末点评估,患者对言语指令失去反应即进入催眠末点,对已进入催眠状态的患者进行麻醉末点评估,以序贯法测定三组催眠、麻醉末点半数有效剂量(ED50),以等辐射分析法分析两者之间催眠、麻醉相互作用。结果在催眠末点:M组ED50为0.18mg/kg(95%CI0.09～0.31mg/kg);K组ED50为0.50mg/kg(95%CI0.38～0.61mg/kg);C组ED50为0.038/0.38mg/kg(95%CI0.024/0.24～0.073/0.73mg/kg),在催眠末点,C组ED50偏离相加线无统计学意义。结论经等辐射分析法证实,咪唑安定与氯胺酮催眠效应上呈现相加作用。Objective To study the hypnotic interaction between midazolam and ketamine during induction of general anesthesia. Methods Ninety patients undergoing were randomly divided into three groups with 30 cases each. Anesthesia was induced with midazolam（group M）, ketamine（group K） or midazolam plus ketamine （group MK）. The ratio of midazolam to ketamine in group MK was 1.： 10. Before induction, each group received different doses of drugs by sequential methods. Failling to respond to verbal orders was regarded as the start-point of hypnotic effect, which was evaluated 2 minutes after drug administration. The ED^0~ of midazolam, ketamine and M-K combination for hypnotic effect were measured by sequential methods. Isobolograrn was drawn to analyze hypnotic interactions between midazolam and ketamine. Results The ED50 for hypnotic effect was 0. 18 mg/kg in group M（95%0 CI 0. 09-0.31 mg/kg） ,0.50 mg/kg in group K（95% CI 0. 38 0. 61 mg/kg）, and 0. 038/0. 38 mg/kg in group C （95% CI 0. 024/0.24-0. 073/0.73 mg/kg）. The deviation of the location of EI50 of M-K combination from the connecting line was not statistically significant. Conclusion The hypnotic interaction between midazolam and ketamine was additive,confirmed by isobolographic analysis.

关 键 词：咪唑安定 氯胺酮 催眠 

分 类 号：R614[医药卫生—麻醉学]