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Sympathoneuronal and sympathoadrenal activation during ketamine anesthesia

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The effects of ketamine anesthesia (3 mg/kg i.v.) on cardiovascular parameters and noradrenaline, adrenaline and dopamine-β-hydroxylase (DBH) activity in plasma were studied in 12 patients. At 3, 6 and 10 min after induction of anesthesia, a pronounced increase in heart rate (+28%) and in systolic and diastolic blood pressure (+28% and 17% resp.) was observed. Concomitantly noradrenaline and adrenaline concentrations increased significantly from 187 to 415 ng/l and from 97 to 271 ng/l, respectively. DBH-activity in plasma remained almost unchanged. From these results it can be concluded that the well known cardiovascular stimulant effect of ketamine is due to greatly enhanced sympatho-neuronal and sympatho-adrenal activity, presumably brought about by a central mechanism of action of the drug. Furthermore, DBH-activity in plasma appeared not to be a reliable index of sympathetic activity in man.

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The study was supported by a grant from the Deutsche Forschungsgemeinschaft.

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Appel, E., Dudziak, R., Palm, D. et al. Sympathoneuronal and sympathoadrenal activation during ketamine anesthesia. Eur J Clin Pharmacol 16, 91–95 (1979). https://doi.org/10.1007/BF00563113

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Key words

  • ketamine
  • sympathoneuronal activity
  • sympathoadrenal activity
  • cardiovascular effects
  • plasma catecholamines