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Sympathoneuronal and sympathoadrenal activation during ketamine anesthesia

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Summary

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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References

  • Appel, E., Simrock, R., Palm, D., Wnuk, A., Dudziak, R.: Enhancement of sympatho-neuronal and sympatho-adrenal activity during ketamine anesthesia. Naunyn-Schmiedeberg's Arch. Pharmacol.297, R 236 (1977)

    Google Scholar 

  • Axelrod, J., Tomchick, R.: Enzymatic O-methylation of epinephrine and other catechols. J. Biol. Chem.233, 702–705, (1958)

    PubMed  CAS  Google Scholar 

  • Badian, M., Appel, E., Palm, D., Rupp, W., Taeuber, K.: Acute increase of dopamine-β-hydroxylase activity (DBH) and catecholamines in human plasma during experimental stress. Pfluegers Arch.373, (Suppl.), R. 57 (1978)

    Google Scholar 

  • Baraka, A., Harrison, T., Kachachi, T.: Catecholamine levels after ketamine anesthesia in man. Anesth. Analg. Current Res.52, 198–200 (1973)

    CAS  Google Scholar 

  • Campbell, R.L.: Effect of atropine on the cardiovascular effects of ketamine HCl. J. Oral Surg.36, 351–355 (1978)

    PubMed  CAS  Google Scholar 

  • Chang, P.: The effects of ketamine on guinea pig heart. Br. J. Anaesth.45, 929–930 (1973)

    PubMed  CAS  Google Scholar 

  • Chang, P., Chan, K.E., Ganendran, A.: Cardiovascular effects of 2-(o-chlorophenyl)-2-methylaminocyclohexanone (CI-581) in rats. Br. J. Anaesth.41, 391–395 (1969)

    PubMed  CAS  Google Scholar 

  • Clanachan, A.S., Mc Grath, J.C.: Effects of ketamine on the peripheral autonomic nervous system of the rat. Br. J. Pharmacol.58, 247–252 (1976)

    PubMed  CAS  Google Scholar 

  • Constantin, B. Condat, P., Jourde, M., Condat, M., Lapallus, P.: Hypertension induite par la ketamine etude experimentale chez le chien. Ann. Anesthesiol. F.13, 473–480 (1972)

    CAS  Google Scholar 

  • Domino, E.F., Chodoff, P., Corssen, G.: Pharmacological effects of CI-581, a new dissociative anesthetic, in man. Clin. Pharmacol. Ther. 6, 279–291 (1965)

    PubMed  CAS  Google Scholar 

  • Dowdy, E.G., Kaya, D.: Studies of the mechanism of the cardiovascular response to CI-581. Anaesthesiology29, 931–943 (1968)

    CAS  Google Scholar 

  • Frankenhäuser, M., Dunnc, E., Lundberg, U.: Sex differences in sympathetic medullary reactions induced by different stressors. Psychopharmacology47, 1–5 (1976)

    Article  Google Scholar 

  • Geffen, L.: Serum dopamine-β-hydroxylase as an index of sympathetic function. Life Sci.14, 1593–1604 (1974)

    Article  PubMed  CAS  Google Scholar 

  • Gemperle, M., Kreuscher, H., Langrehr, D. (eds.): Ketamine. Neue Ergebnisse in Forschung und Klinik. Anaesthesiology and Resuscitation69. Berlin-Heidelberg-New York: Springer 1973

    Google Scholar 

  • Grzanna, R., Coyle, J.T.: Absence of a relationship between sympathetic neuronal activity and turnover of serum dopamine-β-hydroxylase. Naunyn-Schmiedeberg's Arch. Pharmacol.304, 231–236 (1978)

    Article  CAS  Google Scholar 

  • Hagenau, W., Pietsch, D., Arndt, J.O.: Der Effekt von Halothan und Enflurane sowie von Propanidid und Ketamin auf die Aktivität der Barorezeptoren des Aortenbogens decerebrierter Katzen. Anaesthesist25, 331–341 (1976)

    PubMed  CAS  Google Scholar 

  • Hensel, I., Braun, U., Kettler, D., Knoll, D., Martel, J., Paschen, K., Bretschneider, H.J.: Tierexperimentelle Untersuchungen zur Frage der Katecholaminaktivität unter Ketaminnarkose. In: Ketamin. Neue Ergebnisse in Forschung und Klinik. M. Gemperle, H. Kreuscher, D. Langrehr (eds.) Anaesthesiology and Resuscitation69, pp. 63–76. Berlin-Heidelberg-New York: Springer 1973

    Google Scholar 

  • Holtz, P., Palm, D.: Brenzkatechine und andere sympathicomimetische Amine. Ergeb. Physiol.58, 1–580 (1966)

    PubMed  CAS  Google Scholar 

  • Kreuscher, H., Gauch, H.: The effect of the phenciclidine derivative Ketamine (CI-581) on the human vascular system. Anaesthesist16, 229–308 (1967)

    PubMed  CAS  Google Scholar 

  • Lanning, C.F., Harmel, M.H.: Ketamine Anesthesia. Ann. Rev. Med.26, 137–141 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Lundy, P.M., Gowdy, C.W., Colhoun, E.H.: Further experimental evidence of smooth muscle depressant effect of ketamine. Arch. Int. Pharmacodyn. Ther.216, 57–62 (1975)

    PubMed  CAS  Google Scholar 

  • Matsuki, A., Zsigmond, E.K., Kelsch, R.C., Kothary, S.P.: The effect of pancuronium bromide on plasma norepinephrine concentrations during ketamine induction. Can. Anaesth. Soc. J.21, 315–319 (1974)

    Article  PubMed  CAS  Google Scholar 

  • Miletich, D.J., Ivan Koric, A.D., Albrecht, R.F., Zahed, B., Ilahi, A.A.: The effect of ketamine on catecholamine metabolism in isolated perfused rat heart. Anaesthesiology39, 271–277 (1973)

    CAS  Google Scholar 

  • Montel, H., Starke, K., Görlitz, B.-D., Schümann, H.J.: Tierexperimentelle Untersuchungen zur Wirkung des Ketamins auf periphere sympathische Nerven. Anaesthesis22, 111–116 (1973)

    CAS  Google Scholar 

  • Nedergaard, O.A.: Cocain like effects of ketamine on vascular adrenergic neurones. Eur. J. Pharmacol.23, 153–161 (1973)

    Article  PubMed  CAS  Google Scholar 

  • Palm, D., Appel, E., Grobecker, H., Planz, G., Wiethold, G., Simrock, R., Bühring, M., Böhmer, G.: Dopamine-β-hydroxylase activity in plasma as an index of increasing sympathetic activity in man. Abstr. 6th Int. Congr. Pharmacol. Helsinki, p. 490 (1975)

  • Passon, P.G., Peuler, J.D.: A simplified radiometric assay for plasma norepinephrine and epinephrine. Analyt. Biochem.51, 618–631 (1973)

    Article  PubMed  CAS  Google Scholar 

  • Peter, K., Altstaedt, F., Hollmann, G., Klose, R., Mayr, J.: Verhalten der Katecholaminspiegel im Blut während intravenöser Narkose mit Ketamin beim Hund. In: M. Gemperle, H. Kreuscher, D. Langrehr (Eds.): Ketamin. Neue Ergebnisse in Forschung und Klinik. Anaesthesiologie Resuscitation69, pp. 59–76. Berlin-Heidelberg-New York: Springer 1973

    Google Scholar 

  • Planz, G., Palm, D.: Acute enhancement of dopamine-β-hydroxylase activity in human plasma after maximum work load. Eur. J. Clin. Pharmacol.5, 255–258 (1973)

    Article  CAS  Google Scholar 

  • Planz, G., Wiethold, G., Appel, E., Böhmer, D., Palm, D., Grobecker, H.: Correlation between increased dopamine-β-hydroxylase activity and catecholamine concentration in plasma. Determination of acute changes in sympathetic activity. Eur. J. Clin. Pharmacol.8, 181–188 (1975)

    Article  PubMed  CAS  Google Scholar 

  • Rust, M., Landauer, B., Kolb, E.: Stellenwert von Ketamin in der Notfallsituation. Anaesthesis27, 205–212 (1978)

    CAS  Google Scholar 

  • Schwartz, D. A., Horwitz, L. D.: Effects of ketamine on left ventricular performance. J. Pharmacol. Exp. Ther.194, 410–414 (1975)

    PubMed  CAS  Google Scholar 

  • Takki, S., Nikki, P., Jäätelä, A., Tammisto, T.: Ketamine and plasma catecholamines. Br. J. Anaesth.44, 1318–1322 (1972)

    PubMed  CAS  Google Scholar 

  • Tanaka, K., Pettinger, W. A.: Renin release and cardiovascular stimulation in the rat. J. Pharmacol. Exp. Ther.188, 229–233 (1974)

    PubMed  CAS  Google Scholar 

  • Traber, D. L., Wilson, R. D.: Involvement of the sympathetic nervous system in the pressor response to ketamine. Anaesth. Analg. Curr. Res.48, 248–252 (1969)

    CAS  Google Scholar 

  • Traber, D. L., Wilson, R. D., Priano, L. L.: A detailed study of the cardiopulmonary response to ketamine and its blockade by atropine. South. Med. J.63, 1077–1081 (1970a)

    PubMed  CAS  Google Scholar 

  • Traber, D. L., Wilson, R. D., Priano, L. L.: Blockade of the hypertensive response to ketamine. Anesth. Analg.49, 420–426 (1970b)

    PubMed  CAS  Google Scholar 

  • Tweed, W. A., Mymin, D.: Myocardial force-velocity relations during ketamine anesthesia at constant heart rate. Anesthesiology41, 49–52 (1974)

    PubMed  CAS  Google Scholar 

  • Virtue, R. W., Alanis, J. M., Mori, M., Lafargue, R. T., Vogel, J. H. K., Metcalf, D. R. An anesthetic agent: 2-orthochlorophenyl-2-methylamino cyclohexanone HCl (CI-581). Anesthesiology28, 823–833 (1967)

    PubMed  CAS  Google Scholar 

  • Weinshilboum, R., Axelrod, J.: Serum dopamine-β-hydroxylase activity. Circ. Res.28, 307–315 (1971)

    PubMed  CAS  Google Scholar 

  • Zsigmond, K., Kelsch, R. C.: Elevated plasma norepinephrine concentrations during ketamine anesthesia. Clin. Pharmacol. Ther. (Abstr.)14, 149–150 (1973)

    Google Scholar 

  • Zsigmond, E. K., Kelsch, R. C., Kothary, S. P., Vadnay, L.: Free norepinephrine concentrations during induction of anesthesia with ketamine. Rev. Brasil. Anesth.22, 443–451 (1972)

    Google Scholar 

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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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  • DOI: https://doi.org/10.1007/BF00563113

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