제왕절개술시 전신마취유도제로서 Thiopental Sodium 과 Ketamine 의 병용에 관한 연구

• Published in: Korean journal of anesthesiology Vol. 21; no. 6; pp. 947 - 954
• Main Authors: 김현명, Hyun Myung Kim, 강금이, Keum Yi Kang, 윤영무, Young Moo Youn, 이상귀, Sang Kyi Lee, 최훈, Huhn Choe
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 30-11-1988
• ISSN: 2005-6419; 2005-7563

The incidence of C-sections has increased up to 15-20% and general anesthesia for C-sections isulually induced with thiopental or ketamine. Thiopental can produce significant fetal depression in doses higher than 4 mg/kg and ketamine can cause dysphoria. The purpose of this study was to evaluate the possibility of minimizing untoward effects of both drugs by conbination of the two. Sixty-four pregnant women who underwent general anesthesia and C-section received thiopental 5mg/kg (n=24); ketamine 1 mg/kg (n=19); or a combination of thipental 2.5mg/kg and ketamine 0.5mg/kg (n=21). The results were as follows: 1. At endotracheal intubation, mean arterial pressure, pulse rate, systolic blood pressure, and rate pressure product were increased from the values before anesthetic inducion but there was no statistical significance among groups(p>0.05). 2. The patient`s movenment to the strong stimulus of skin incision and intraoperative awarencss were lower in the ketamine group and higher in the combined group. 3. The induction-delivery interval and uterine incision-delivery interval did not differ significantly among groups. 4. The incidence of 1 and 5 min Apgar scores below 7 was highest in the thiopental group and lowest in the ketamine group. 5. Postoperative recalling of intraoperative awareness occurred in two patinets only in the combined group. 6. PAR scores in the recovery room did not differ significantly among 3 groups. From the above results, the combination of thiopental and ketamine appeared to offer little advantage over thiopental or ketamine. ketamine (1mg/kg) was though to be appropriate for the induction of anesthesia for C-sections with respect to the incidence of intraoperative awareness, patient`s movement to surgical stimuli, and neonatal Apagar scores.