首页|氯胺酮和艾司氯胺酮对手术患者血流动力学影响的研究进展

氯胺酮和艾司氯胺酮对手术患者血流动力学影响的研究进展

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在临床手术中,各类麻醉药物对患者的血液循环产生不同影响,如丙泊酚和吸入性麻醉药等可能导致剂量相关的心血管抑制,同时伴随着交感神经张力的下降、血管阻力的减少及容易诱发术后低血压。氯胺酮可以激活交感神经系统导致儿茶酚胺的释放同时抑制迷走神经,从而在临床上表现为血压升高、心率增快等心血管兴奋特征。作为氯胺酮的右旋异构体,艾司氯胺酮(S-氯胺酮)不仅保留了氯胺酮的特性,而且副作用也相对较小,目前已经被用于临床麻醉诱导和维持、镇痛及治疗难治性抑郁症。该文将氯胺酮和S-氯胺酮对全身麻醉血流动力学的影响进行全面概述。
Study advances in effects of ketamine and esketamine on hemodynamics in surgical patients
In clinical surgery,various anesthetic drugs produce different effects on the blood circulation of patients.For example,propofol and inhaled anesthetics may lead to dose-related cardiovascular depression,meanwhile which is accompanied by sympathetic nerve tensile decline,vascular resistance decrease and is easy to induce postoperative hypotension.Ketamine can activate the sympathetic nervous system leading to release catecholamines and inhibit the vagus nerve,thus which is clinically manifested as increased blood pressure,in-creased heart rate and other cardiovascular excitation characteristics.As the dextroisomer-isomer of ketamine,esketamine(S-ketamine)not only retains the properties of ketamine,but also has relatively few side effects.Currently,it has been used in clinical anesthesia induction and maintenance,analgesia and treatment of refrac-tory depression.This paper provides a comprehensive overview of the effects of ketamine and S-ketamine on the hemodynamics of general anesthesia.

ketamineesketaminehemodynamicsanesthetic drugsreview

王姝、郭巧、陈元敬、段光友、黄河

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重庆医科大学附属第二医院麻醉科,重庆 400010

氯胺酮 艾司氯胺酮 血流动力学 麻醉药物 综述

2024

重庆医学
重庆市卫生信息中心,重庆市医学会

重庆医学

CSTPCD
影响因子:1.797
ISSN:1671-8348
年,卷(期):2024.53(24)