DIFFERENTIAL-EFFECTS OF KETAMINE AND MIDAZOLAM ON HEART-RATE-VARIABILITY
DIFFERENTIAL-EFFECTS OF KETAMINE AND MIDAZOLAM ON HEART-RATE-VARIABILITY
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DOI：
10.1007/bf03011073
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发表时间：
1995-11-01
期刊：
影响因子：
--
通讯作者：
SHIMADA, Y
中科院分区：
文献类型：
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作者：
KOMATSU, T;SINGH, PK;SHIMADA, Y
麻醉引起的自主神经活动的改变可以通过心率变异性(HRV)的频谱分析来评估。本研究考察了氯胺酮和咪达唑仑对心率变异性的影响。对30例ASA-PS-1患者进行研究。15人注射氯胺酮(2 mg。Kg(-1)，15例给予咪达唑仑(0.3 mg.Kg(-1))，iv。分别于麻醉诱导前和麻醉诱导后10min测量心率变异性间期。利用FART Farrier变换计算数据的功率谱密度。计算每次测量的频谱峰值：低频(低频，0.04~0.15赫兹)、高频(高频，0.15~0.5赫兹)和总功率(TP，0.04~0.5赫兹)。归一化单位功率计算公式如下：低频区(NuLF)：LF/TP X 100%，高频区(NuHF)：HF/TP X 100%。氯胺酮和咪达唑仑均导致心率变异性功率的所有测量结果降低(P<；0.05)。然而，氯胺酮使nuLF从的+/-14%增加到75+/-13%(P<；0.05)，使nuHF从36+/-14%降低到25+/-13%(P<；0.05)，咪达唑仑使nuLF从66+/-15%降低到54+/-14%(P<；0.05)，nuHF从34+/-15%增加到46+/-14%(P<；0.05)。这些结果表明，氯胺酮和咪达唑仑都降低了总功率和功率的所有频率分量，尽管它们对自主神经活动有相反的影响。然而，由于氯胺酮增加了nuLF，咪达唑仑降低了nuLF，归一化单位功率显示了氯胺酮对交感神经的预期激活和咪达唑仑对交感神经的抑制。
Alterations in autonomic activity caused by anaesthesia can be assessed by spectral analysis of heart rate variability (HRV). This study examined the effects of ketamine and midazolam on HRV. Thirty patients of ASA PS 1 were studied. Fifteen were given ketamine (2 mg . kg(-1) and 15 received midazolam (0.3 mg . kg(-1)), iv. The RR intervals of ECG were measured before and after induction of anaesthesia for ten minutes during spontaneous respiration. Power spectral density of the data was computed using fart Farrier transform. The spectral peaks within each measurement were calculated low frequency area (LF, 0.04-0.15 Hz), high frequency area (HF, 0.15-0.5 Hz), and total power (TP, 0.04-0.5 Hz). Normalized unit power was derived as follows: low frequency area (nuLF): LF/TP X 100%, high frequency area (nuHF): HF/TP X 100%. Both ketamine and midazolam caused reductions in all measurements of HRV power (P < 0.05). However, ketamine increased nuLF from 64 +/- 14% to 75 +/- 13% (P < 0.05) and decreased nuHF from 36 +/- 14% to 25 +/- 13% (P < 0.05), while midazolam decreased nuLF from 66 +/- 15% to 54 +/- 14% (P < 0.05) and increased nuHF from 34 +/- 15% to 46 +/- 14% (P < 0.05). These results documented that both ketamine and midazolam reduced the total power and all frequency components of power in spite of their opposing effects on autonomic nervous activity. However, normalized unit power showed the expected sympathetic activation with ketamine and sympathetic depression with midazolam since ketamine increased nuLF and midazolam decreased nuLF.