In addition to its use for intravenous (I.V.) anesthesia, ketamine can provide pain relief in humans when administered spinally. To elucidate the mechanisms of intrathecal (I.T.) ketamine analgesia, we observed differences in the effects of I.V. and I.T. ketamine on intraspinal evoked potentials (ISEPs) in 28 dogs anesthetized with pentobarbital. Bipolar extradural electrodes were inserted at the cervical and lumbar regions of the spinal cord for recording descending ISEPs represented by the two negative deflections, Waves I and II. I.V. ketamine 2 and 10 mg/ kg did not affect the amplitude and latency of Wave I, whereas the large dose (10 mg/kg) significantly decreased the amplitude but not the latency of Wave II. I.T. ketamine 1 and 5 mg/kg caused significant dose-dependent decreases in both Wave I and II amplitudes and prolongations of both Wave I and II latencies. These I.T. effects on ISEPs are consistent with previous in vitro observations that ketamine blocks axonal conduction. We conclude that axonal conduction block may contribute to the analgesic mechanism of I.T. ketamine.

译文

除了用于静脉注射 (静脉注射) 麻醉外,氯胺酮还可以减轻脊柱注射时的疼痛。为了阐明鞘内 (I.T.) 氯胺酮镇痛的机制,我们观察了静脉注射和静脉注射氯胺酮对28只用戊巴比妥麻醉的狗的椎管内诱发电位 (ISEPs) 的影响。将双极硬膜外电极插入脊髓的颈椎和腰椎区域,以记录由两个负偏转波I和II表示的下降ISEPs。静脉内氯胺酮2和10 mg/kg不影响第I波的振幅和潜伏期,而大剂量 (10 mg/kg) 显着降低了振幅,但不影响第II波的潜伏期。I.T. 氯胺酮1和5 mg/kg引起I和II波振幅的显着剂量依赖性降低,以及I和II波潜伏期的延长。这些I.T. 对ISEPs的影响与先前的体外观察结果一致,即氯胺酮可阻断轴突传导。我们得出的结论是,轴突传导阻滞可能有助于i.T.氯胺酮的镇痛机制。

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