BACKGROUND: When used for induction of anesthesia, ketamine usually increases intraocular pressure (IOP). However, the effect of low doses of ketamine, which are used for parental separation in children, is unknown. We studied the effect of two different doses of ketamine on IOP in anesthetized children. METHODS: Forty children age 1 to 6 years who met American Society of Anesthesiologists physical status I criteria scheduled to undergo surgery were randomly selected to receive either an induction dose (6 mg/kg) or a low dose (3 mg/kg) of ketamine intramuscularly. Anesthesia was induced and maintained with halothane, and ketamine was injected 10 minutes after induction. Intraocular pressure was measured using a Perkins applanation tonometer before ketamine administration and every 5 minutes thereafter for 20 minutes by an observer who was unaware of the ketamine dose used. 10.8 +/- 2.2 mm Hg to 12.6 +/- 2.8 mm Hg at 5 minutes and 11.9 +/- 2.5 mm Hg at 10 minutes after administration of ketamine in the induction-dose group. There was no significant change in IOP after administration of ketamine in the low-dose group. Intraocular pressure was significantly higher in the induction-dose group compared to the low-dose group at 5 minutes after administration of ketamine. More patients in the induction-dose group had postoperative airway obstruction and sedation than in the low-dose group. CONCLUSIONS: In children anesthetized with halothane, ketamine had a dose-dependent effect on IOP, with 6 mg/kg of the drug causing a small increase in IOP at 5 to 10 minutes and 3 mg/kg not altering the IOP. The higher dose of ketamine also was associated with an increased incidence of postoperative complications.
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机译：背景：氯胺酮用于诱导麻醉时，通常会增加眼内压（IOP）。然而，用于儿童父母分离的低剂量氯胺酮的作用尚不清楚。我们研究了两种不同剂量的氯胺酮对麻醉儿童的眼压的影响。方法：随机选择计划接受手术的，符合美国麻醉医师学会I级身体状况的40位1至6岁儿童，以诱导剂量（6 mg / kg）或低剂量（3 mg / kg）的氯胺酮接受治疗肌肉内。氟烷诱导并维持麻醉，诱导后10分钟注射氯胺酮。在氯胺酮给药之前，使用Perkins压平眼压计测量眼内压，此后每5分钟由不知道所用氯胺酮剂量的观察者测量20分钟。在诱导剂量组中施用氯胺酮后，在5分钟时的10.8 +/- 2.2 mm Hg至12.6 +/- 2.8 mm Hg，在10分钟时的11.9 +/- 2.5 mm Hg。低剂量组服用氯胺酮后眼压没有明显变化。氯胺酮给药后5分钟，诱导剂量组的眼压明显高于低剂量组。与低剂量组相比，诱导剂量组术后气道阻塞和镇静的患者更多。结论：在氟烷麻醉下的儿童中，氯胺酮对眼压具有剂量依赖性，其中6 mg / kg的药物在5至10分钟时引起IOP的小幅增加，而3 mg / kg不会改变IOP。较高剂量的氯胺酮还与术后并发症发生率增加有关。
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