Summary
Ketamine 2.0 mg/kg alone with nitrous oxide-oxygen inhalation caused a rise in blood pressure, pulse rate and frée nor-epinephrine levels in plasma in twelve elective surgical patients. Contrary to expectations, the combination of ketamine with pancuronium during nitrous oxide-oxygen inhalation caused no rise in nor-epinephrine in plasma and reduced the rise in arterial blood pressure and pulse rate. No intubation, surgical preparation, or positional changes were allowed. No hypoxia or hypercarbia was demonstrated by the blood gas studies. The mechanism of this blocking effect of pancuronium on ketamine-induced nor-epinephrine rise await clarification by further laboratory and clinical experiments. The combination of ketamine with pancuronium, can therefore be safely employed in patients in whom marked circulatory changes should be avoided.
Résumé
La Ketamine à la dose de 2.0 mgm/kg, employée seule avec le protoxyde d’azote-oxygène en inhalation, produisit une élévation de la pression sanguine, de la fréquence cardiaque et des niveaux plasmatiques de nor-épinéphrine libre chez douze malades soumis à une chirurgie élective. Contrairement aux prévisions, l’association de Ketamine avec le Pancuronium durant 1’inhalation de protoxyde d’azote-oxygène n’amena aucune élévation de nor-épinéphrine libre dans le plasma et diminua l’élévation de la tension artérielle et de la fréquence cardiaque. L’intubation, la préparation chirurgicale et les changements de posture étaient interdits. L’étude des gaz sanguins ne démontra aucune hypoxie ni hypercarbie. Le mécanisme de cet effet de blocage du Pancuronium sur l’élévation de nor-épinéphrine suscitée par la Ketamine doit attendre, pour trouver son explication, de plus amples essais en laboratoire et en clinique. L’association de la Ketamine avec le Pancuronium peut done être utilisée avec sécurité chez les malades où l’on doit éviter des changements circulatoires marqués.
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Matsuki, A., Zsigmond, E.K., Kelsch, R.C. et al. The effect of pancuronium bromide on plasma nor-epinephrine concentrations during ketamine induction. Canad. Anaesth. Soc. J. 21, 315–320 (1974). https://doi.org/10.1007/BF03005736
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DOI: https://doi.org/10.1007/BF03005736