Abstract
Ketamine (1 mg·kg-1) or thiopentone (4mg·kg-1) was used to induce anaesthesia for Caesarean section in 62 normotensive patients. During induction of anaesthesia and before laryngoscopy, blood pressure did not change in either group (preinduction systolic blood pressure, 131 mmHg, and diastolic blood pressure, 75 mmHg). When laryngoscopy and intubation were performed, mean blood pressures of both patient groups increased 20–30 per cent. With ketamine (n = 30) heart rate was unchanged from the preinduction rate of 85 beats/min before laryngoscopy and increased significantly by 15 per cent during laryngoscopy and intubation. With thiopentone (n = 32), heart rate increased significantly to 20 per cent above the preinduction rate of 87 beats/min during induction and increased further (to 35 per cent above the preinduction rate) during laryngoscopy and intubation. The average maximal rate-pressure product calculated for the thiopentone group was over 18,000, which was significantly higher than the 15,000 calculated for the ketamine group. Neonatal outcome as assessed by Apgar score and umbilical blood gas analysis was good and did not differ significantly between groups.
Résumé
La kétamine (1 mg·kg-1) ou le thiopentone (4 mg·kg-1) a été utilisé comme agent d’induction chez 62 patientes normotensives devant subir une césarienne. Lors de l’induction et avant la laryngoscopie, la tension artérielle n’a pas changé dans aucun des deux groupes (la tension artérielle systolique après induction, 131 mmHg, et la pression artérielle diastolique, 75 mmHg). Lors de la laryngoscopie et l’intubation la tension artérielle dans les deux groupes augmenta de 20 à 30 pour cent. Avec la ketamine (n = 30) la fréquence cardiaque qui était de 85 battements/min. avant l’induction n’a pas changée lors que l’induction et avant la laryngoscopie. Cependant on observa une augmentation significative de 15 pour cent lors de la laryngoscopie et l’intubation. Avec le thiopentone (n = 32) la fréquence cardiaque qui était de 87 battements/min. avant l’induction augmenta significa-tivement de 20 pour cent lors de l’induction et avant la laryngoscopie. Cette augmentation de la fréquence cardiaque atteint 35 pour cent lors de la laryngoscopie et l’intubation. Le produit de la fréquence cardiaque par la pression maximale moyenne, calculé pour le groupe thiopentone était supérieur à 18,000, significativement supérieur à celui du groupe kétamine calculé à 15,000. Concernant les nouveaux-nés évalués par les tests d’Apgar et l’analyse des gaz sanguins du cordon ombilical le résultat final était considéré bon et n’a pas différé significativement entre les deux groupes.
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Schultetus, R.R., Paulus, D.A. & Spohr, G.L. Haemodynamic effects of ketamine and thiopentone during anaesthetic induction for Caesarean section. Can Anaesth Soc J 32, 592–596 (1985). https://doi.org/10.1007/BF03011404
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DOI: https://doi.org/10.1007/BF03011404