Einfluss von S-(+)-ketamin auf die autoregulation der hirndurchblutung

Purpose: The present study investigates the effects of S-(+)-ketamine on cerebral blood flow (CBF) autoregulation in rats. Methods: Following IRB approval, 24 nonfasted male Sprague-Dawley rats were anesthetised with isoflurane, intubated and mechanically ventilated. Catheters were inserted into the right femoral artery. both femoral veins, and into the right jugular vein for drug administration, measurement of mean arterial blood pressure (MAP), and blood sampling. Cortical cerebral blood flow was measured using laser-Doppler-flowmetry (PF 403, Perimed(TM)). At the end of surgery isoflurane was discontinued and all animals were randomly assigned to one of the following anaesthetic treatments. In group 1 (n = 8, control), anaesthesia was maintained using fentanyl (10 μg/kg i.v. bolus, followed by 25 μg/kg/h i.v.) and N₂O/O₂ (FiO₂: 0.3). In group 2 (n=8) and group 3 (n=8) animals received 0.5 mg/ kg/min S-(+)-ketamine i.v. or 1.0 mg/kg/min S- (+)-ketamine i.v. and O₂/air (FiO₂: 0.3), respectively. CBF was tested by graded haemorrhage. Arterial blood gases, arterial pH, and pericranial temperature were controlled over time. Results: CBF autoregulation was maintained under low and high doses of S-(+)-ketamine compared to fentanyl/N₂O-anaesthetised controls. However, low-dose S-(+)-ketamine shifted the autoregulatory curve towards higher MAP values. Conclusions: The present study indicates that autoregulatory cerebrovascular dilation is preserved with low and high doses of S-(+)-ketamine. Differences in the lower limit of CBF autoregulation may be consistent with an increased sympathetic tone induced by low doses of S-(+)-ketamine.