| Japanese |
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| Title | 肺高血圧合併患者におけるケタミンの有用性に関する研究 |
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| Subtitle | 原著 |
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| Authors | 近藤泉* |
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| Authors(kana) | |
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| Organization | *東京女子医科大学麻酔学教室 |
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| Journal | 循環制御 |
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| Volume | 12 |
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| Number | 3 |
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| Page | 513-521 |
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| Year/Month | 1991/ |
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| Article | 原著 |
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| Publisher | 日本循環制御医学会 |
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| Abstract | 「要旨」肺高血圧を伴う僧帽弁疾患患者を対象として, ジアゼパム2.5mg, ケタミン1mg/kg, フェンタニール20μg/kg, パンクロニウム0.15mg/kg, さらに執刀後10μg/kgを静注(KF群)し, 導入から胸骨切開後までの血行動態及び内因性カテコラミンを測定した. 対照群として, 就眠量のジアゼパム5〜10mg, フェンタニール15μg/kg, パンクロニウム0.15mg/kg, 執刀後フェンタニール15μg/kgを静注した群(F群)を同様に測定し, KF群と比較検討した. KF群では, 平均動脈圧, 平均肺動脈圧は変化がなかったが, F群では, 挿管後に平均動脈圧の低下傾向が見られた. 導入後の血中ノルエピネフリン濃度は, KF群では変化がなかったが, F群では有意に低下していた. ジアゼパム, ケタミン, フェンタニールによる導入方法は, 肺高血圧を伴う僧帽弁疾患患者において, 有用な導入方法の1つであると考えられた. |
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| Practice | 基礎医学・関連科学 |
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| Keywords | ketamine, pulmonary hypertension, mitral valve disease, plasma cathecholamine |
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| English |
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| Title | Hemodynamic Effects of Ketamine during Induction of Anesthesia for Pulmonary Hypertention |
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| Subtitle | |
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| Authors | Izumi Kondo |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology Tokyo Women's Medical College |
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| Journal | Circulation Control |
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| Volume | 12 |
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| Number | 3 |
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| Page | 513-521 |
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| Year/Month | 1991/ |
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| Article | Original article |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | We have studied the hemodynamic effects of ketamine in 19 patients with mitral valve disease and pulmomary hypertention. Nine patients (KF group) were administered diazepam 2.5 mg, ketamine 1 mg/kg and fentanyl 20 μg/kg at induction and an additional 10 μg/kg of fentanyl after incision. The remaining 10 patients were (F group) administered diazepam 5-10 mg, fentanyl 15 μg/kg at induction and an additional 15 ug/kg of fentanyl after incision. In both groups the hemodynamic changes and plasma catecholamine concentration were measured at the control state (preanesthetic levels), after induction, intubation, incision and sternotomy. In the F group, the HR, MAP, and MPAP decreased sigriificantly from 91±27 (Mean±SD) at the control state to 75±16 beats/min after incision, and from 88±22 at the control state to 77±10 mmHg after induction, and from 29.8±8.8 at the, control state to 25.6±9.7mmHg after incision (p<0.05). The SVR decreased from 1776±590 at the control state to 1378±530 dynes・sec・cm-5 after induction. Also the plasma catecholamine concentration decreased significantly from 454±243 at the control state to 335±213 after the incision, to 224±135 at incision and to 306±213 μg/ml after sternotomy. In the KF group, the HR, MAP did not significantly increase. However the MPAP decreased from 40.4±12.4 at the control state to 27.6±10.5 mmHg after incision, and the SVR increased from 1628±281 at the control state to 1909±387 dynes・sec・cm-5 after induction. Also the plasma catecholamine concentration did not change. The values of CVP, CI and SVI did not change in both groups. These results suggest that the combained administration of fentanyl, ketamine and diazepam during induction is useful for the patients with mitral valve disease and pulmonary hypertention. |
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| Practice | Basic medicine |
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| Keywords | ketamine, pulmonary hypertension, mitral valve disease, plasma cathecholamine |
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