RESPIRATORY INTERACTIONS OF KETAMINE AND MORPHINE
RESPIRATORY INTERACTIONS OF KETAMINE AND MORPHINE
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DOI：
10.1097/00000542-198702000-00008
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发表时间：
1987-02-01
期刊：
影响因子：
8.8
通讯作者：
SMITH, TC
中科院分区：
文献类型：
--
作者：
BOURKE, DL;MALIT, LA;SMITH, TC
六名健康、自愿的男性志愿者接受了氯胺酮静脉注射，剂量为 5 个对数剂量，每次 3 毫克/公斤，每次 3 次。这些疗程的不同之处仅在于最初注射了一种未知药物：安慰剂、硫酸吗啡 0.2 毫克/公斤或硫酸吗啡 0.4 毫克/公斤。给药期间对 CO2 (.ovrhdot.VERCO2) 和等高碳酸通气 (呼气末 CO2 49.8 .+-. 2.4 mmHg) 的初始和终末稳态通气反应评估了 CO2 介导的通气驱动。 40%的氧气浓度消除了缺氧驱动的贡献。吗啡导致等高碳酸通气 (.ovrhdot.VE) 降低 8.2 .+-。 0.2 mg/kg 后为 1.2 l/min。将剂量加倍至 0.4 mg/kg 进一步抑制 6.6 ±。 1.8 升/分钟。没有受试者在吗啡后失去知觉。在 0.39 至 3.0 mg/kg 的剂量范围内，氯胺酮引起 1.6 ± 的对数线性剂量相关抑制。 0.3 l/min 达到剂量加倍，尽管第一次显着降低 4.9 .+-。在没有吗啡的情况下，直到第三剂（1.1 mg/kg）才出现 1.1 l/min。所有受试者在服用 1.8 mg/kg 氯胺酮后均失去知觉。无论两个剂量中的预处理、安慰剂或吗啡如何，.ovrhdot.VERCO2 的斜率与对照没有差异。单独的氯胺酮，3.0mg/kg，导致.ovrhdot.VERCO2的位移+2.0.+-。 CO 2 中为1.2mmHg，而任一剂量的氯胺酮和吗啡的组合导致.ovrhdot.VERCO2+10mmHg的位移。因此，氯胺酮在抑制呼吸方面与术前剂量的吗啡在性质上相似，但效力较弱，尽管其造成意识丧失的效果几乎相同。
Six healthy, consenting volunteer males received ketamine iv in five logarithmically scaled doses totaling 3 mg/kg on three occasions each. The sessions differed only in the initial injection of an unknown drug: placebo, morphine sulfate 0.2 mg/kg, or morphine sulfate 0.4 mg/kg. Initial and terminal steady-state ventilatory responses to CO2 (.ovrhdot.VERCO2) and isohypercapnic ventilation (end-tidal CO2 49.8 .+-. 2.4 mmHg) during drug administration assessed CO2-mediated ventilatory drive. Oxygen concentration of 40% ablated hypoxic drive contribution. Morphine caused a decrease of isohypercapnic ventilation (.ovrhdot.VE) of 8.2 .+-. 1.2 l/min after 0.2 mg/kg. Doubling the dose to 0.4 mg/kg gave a further depression of 6.6 .+-. 1.8 l/min. No subject lost consciousness after morphine. Over a dose range of 0.39 to 3.0 mg/kg ketamine caused log-linear dose-related depression of 1.6 .+-. 0.3 l/min of reach doubling of dose, although the first significant depression of 4.9 .+-. 1.1 l/min did not occur until the third dose (1.1 mg/kg) in the absence of morphine. All subjects were unconscious after 1.8 mg/kg ketamine. Slopes of the .ovrhdot.VERCO2 did not differ from control, regardless of the pretreatment, placebo, or morphine in the two doses. Ketamine alone, 3.0 mg/kg, caused a displacement of .ovrhdot.VERCO2 of +2.0 .+-. 1.2 mmHg in CO2, while combination of ketamine and morphine in either dose caused a +10 mmHg displacement of .ovrhdot.VERCO2. Thus, ketamine appears qualitatively similar but less potent than premedicant doses of morphine in depressing respiration despite near equipotency in producing loss of consciousness.