氯胺酮的抗惊厥作用及对兔呼吸、血压的影响_医学论文.docVIP

氯胺酮的抗惊厥作用及对兔呼吸、血压的影响_医学论文 氯胺酮的抗惊厥作用及对兔呼吸、血压的影响_医学论文 【摘要】 目的 观察氯胺酮在治疗士的宁惊厥时对兔呼吸、循环的影响。方法 健康成年家兔50只，雌雄不拘，随机分成K1.25、K2.5、K5.0、NS和PB5.0组，每组10只。清醒状态局部麻醉作用下行股动脉插管、剑突穿线，测定兔股动脉血压和呼吸频率。兔耳缘静脉注射士的宁0.25 mg/kg制作惊厥模型，强直惊厥出现后立即静脉注射治疗药物。观察各组兔的死亡数、强直持续时间、呼吸频率和股动脉血压情况。结果 氯胺酮大、中、小3个剂量组与NS组和PB5.0组相比，兔强直持续期明显缩短（0.01），且呈剂量依赖性（r=-0.8696，0.05）。K2.5、K5.0和PB5.0组死亡均为零。氯胺酮各剂量组呼吸频率在注药后2~5 min内比基础值提高（0.01）。氯胺酮各剂量组股动脉血压在注药后2、5 min时高于PB5.0组（0.05），在5、10 min时高于NS组（0.05）。结论 氯胺酮能对抗士的宁诱发的惊厥，明显改善惊厥兔的呼吸、循环。 【关键词】 氯胺酮；抗惊厥；呼吸；血压 Abstract:Objective To observe the effects of ketamine (K) on respiration and circulation during its therapeutic use against drug-induced convulsion in rabbits.Methods Fifty rabbits of both sexes were randomly divided into K1.25 (mg/kg), K2.5 (mg/kg), K5.0 (mg/kg), NS (0.5 ml/kg) and PB5.0 (phenobarbital, 5.0 mg/kg) groups. Convulsion was induced with intravenous strychnine (0.25 mg·kg-1) within 15 seconds. Drug treatment was administered intravenously once convulsion occurred. Convulsant latency, duration of tonic state, mortality, rate of respiration and femoral artery blood pressure were noted.Results Ketamine could dose-dependently shorten the duration of tonic state induced by strychnine (0.05, r=0.8696). The mortality was 4/10 in the NS group and zero in the K2.5, K5.0 and PB5.0 groups. The varied doses of ketamine stimulated the depressed respiration for 2~5 min (0.01). The femoral artery blood pressure was higher in the K groups than in the NS and PB5.0 groups (0.05).Conclusion Ketamine can antagonize the strychnine-induced convulsion and improve the respiration and blood pressure in the convulsive rabbits. Key words: ketamine anti-convulsion respiration circulation 惊厥（convulsion）是由于中枢神经系统过度兴奋引起的骨骼肌不自主和不协调的抽搐，是临床常见症状。许多疾病伴发或者药物过量、中毒均可引起惊厥，最终可能导致呼吸抑制、昏迷甚或死亡。目前临床上常用的抗惊厥药（如巴比妥类）中枢抑制选择性不高或者对呼吸、循环抑制较重，作用时间较长，常与惊厥后期的“抑制相”叠加而加重中枢抑制作用［1］，使得患者昏迷时间延长，血压不易维持。故这些传统的抗惊厥药使用时顾虑较多，急需寻找作用快而强，维持时间短，且对呼吸、循环抑制轻的抗惊厥药。新型的抗惊厥药丙泊酚(propofol)的抗惊厥作用尽管作用时间短，但是由于该药对呼吸、循环抑制较为明显，并不能降低惊厥动物死亡率［2~4］。同