Influence of Anesthesia Induction with Ketamine on Baroreflex Control of Heart Rate. |
Jun Gol Song, Won Jung Shin, In Gu Jun, Su Jin Kang, Byung Moon Choi, Mi Ok Youn, Tae Hee Kim, Young Kug Kim, In Young Huh, Seong Sik Kang, Gyu Sam Hwang, Sung Min Han |
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. kshwang@amc.seoul.kr 2Department of Anesthesiology and Pain Medicine, Ulsan Univiersity Hospital, Korea. 3Department of Anesthesiology and Pain Medicine, Kangwon National University Medical School, Chuncheon, Korea. |
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Abstract |
BACKGROUND It is reported that ketamine increases central sympathetic activity as well as catecholamine reuptake inhibition. However, little has been known about baroreflex control of heart rate in ketamine anesthetized humans. Thus, the aim of this study was to analyze the effect of ketamine on spontaneous baroreflex sensitivity (BRS) during ketamine induction of anesthesia. METHODS Beat-by-beat arterial blood pressure and electrocardiogram at 5 min before and 10 min after ketamine administration (2 mg/kg) were recorded in twenty healthy living liver transplant donors. Spontaneous BRS was assessed by sequence method and transfer function analysis method. RESULTS Spontaneous BRS assessed by sequence method, BRSsequence, decreased from 13.7 +/- 6.3 to 7.8 +/- 4.5 ms/mmHg (P < 0.001). Spontaneous BRS assessed by low frequency transfer function method decreased from 10.9 +/- 5.4 to 7.0 +/- 4.1 ms/mmHg and by high frequency transfer function method from 14.8 +/- 9.2 to 8.7 +/- 8.8 ms/mmHg, respectively (P < 0.05). CONCLUSIONS The spontaneous BRS was decreased during ketamine induction of general anesthesia. These results suggest that anesthesia induction with ketamine impairs baroreflex control of heart rate, which may provoke hemodynamic instability. |
Key Words:
heart rate; ketamine; spontaneous baroreflex sensitivity |
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