Abstract
The neuromuscular effects of ketamine, at cumulative doses of 2.5 and 10 mg · kg−1 iv, were studied by electromyographically quantifying the thumb response evoked by ulnar nerve stimulation in 25 monkeys anaesthetized with pentobarbital-N2O-O2. Ketamine alone at these doses had no neuromuscular effects. When the EMG response was maintained at 50% of control by a continuous infusion of magnesium, vecuronium, or pancuronium, ketamine depressed the responses by an additional 13 ± 3%, 34 ± 7% and 32.5 ± 3.3% (mean ± SEM), respectively, at the highest dose, P < 0.05. In contrast, ketamine had no effect on the neuromuscular block produced by incremental doses of alphabungarotoxin. These results indicate that ketamine does not act on the postjunctional acetylcholine receptor. It plays a secondary role in neuromuscular block, possibly by prejunctional or postjunctional effects independent of receptor occupation.
Résumé
Les effets neuromusculaires de la kétamine, à des doses cumulatives de 2,5 à 10 mg · kg−1 iv, ont été étudiés en quantifiant par méthode électromyographique la réponse du pouce obtenue par la stimulation du nerf cubital chez 25 singes anesthésiés avec pentobarbital, protoxyde d’azote et oxygène. A ces doses, la kétamine seule n’avait aucun effet neuromusculaire. Lorsque la réponse électromyographique était maintenue à 50% de la valeur de base par une infusion continue de magnésium, vécuronium ou pancuronium, la kétamine diminuait les réponses d’une valeur additionnelle de 13 ± 3%, 34 ± 7% et 32,5 ±3,3% (moyenne ± ET) respectivement, à la dose la plus élevée, P < 0,05. D’un autre côté, la kétamine n’avait aucun effet sur le bloc neuromusculaire produit par des doses progressives d’alphabungarotoxine. Ces résultats montrent que la kétamine n’agit pas sur les récepteurs postjonctionnels de l’acétylcholine. Elle joue un rôle secondaire dans le bloc neuromusculaire, possiblement par des effets préjonctionnels ou postjonctionnels indépendants de l’occupation des récepteurs.
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Tsai, SK., Liao, KT. & Lee, C. Modification by ketamine on the neuromuscular actions of magnesium, vecuronium, pancuronium and alpha-bungarotoxin in the primate. Can J Anaesth 39, 79–82 (1992). https://doi.org/10.1007/BF03008679
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DOI: https://doi.org/10.1007/BF03008679