Br J Anaesth:氯胺酮诱发的人类志愿者脑电图慢波动力学和行为反应消失

2019-11-29 anesthGH “罂粟花”微信号

前期关于麻醉剂量氯胺酮对脑电图 (EEG)影响的研究已经证实了增强高频波(β-γ)和θ波与周期性慢波交替的典型特征。目前尚不清楚哪种脑电图参数是氯胺酮催眠作用药代动力学-药效学模型的最佳参数,或哪种脑电图参数与行为反应消失最为密切。

背景与目的

前期关于麻醉剂量氯胺酮对脑电图 (EEG)影响的研究已经证实了增强高频波(β-γ)和θ波与周期性慢波交替的典型特征。目前尚不清楚哪种脑电图参数是氯胺酮催眠作用药代动力学-药效学模型的最佳参数,或哪种脑电图参数与行为反应消失最为密切。

方  法

我们重新分析了之前发表的来自15名受试者的128通道头皮脑电图数据,这些受试者均注射了1.5 mg·kg-1剂量的氯胺酮。我们将标准S形药代动力学-药效学模型应用于药物引起的慢波活动、θ和β-γ脑电图功率的变化;并监测Fz、F3、T3、P3、Pz平均参考通道的慢波时域形态。

结 果

静脉注射催眠剂量的氯胺酮可诱发额叶中段脑电图慢波,当预计脑浓度为1.64 (0.17) mg·ml-1时,行为反应消失。慢波活动明显减弱后,行为反应恢复出现于1.06 (0.21) mg.ml-1浓度时。药代动力学-药效学模型最适合慢波活动和θ波功率(几乎一半的β-γ通道无法建模)。慢波效应位点平衡半衰期(23 [4]s)及偏移量比θ波(47 [22]s)快。

结 论

注射催眠剂量氯胺酮后脑电图慢波活动的改变可以用标准S型剂量-反应模型来模拟。我们研究小组发现,脑电图慢波活动出现(而非慢波活动抵消)始终与行为反应消失有关。

原始出处:

Sleigh J, Pullon RM, Vlisides PE, et al. Electroencephalographic slow wave dynamics and loss of behavioural responsiveness induced by ketamine in human volunteers[J].Br J Anaesth,2019,123(5):592-600.

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    2020-11-11 AspirantSuo
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    2019-12-01 jml2009

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