Acute hypoxic ventilatory response is an important reflex that helps maintain breathing during low oxygen levels, but it is attenuated by most general anaesthetics. Analgesic doses of ketamine and esketamine are known to have respiratory stimulant effects. In their recent study in the British Journal of Anaesthesia, Jansen and colleagues show that low-dose esketamine preserved the acute hypoxic ventilatory response, while increasing breathing rate, systolic blood pressure, and heart rate. Participants also exhibited higher levels of alertness and unpleasant psychotropic effects compared with the control condition. We review the pharmaco-physiological effects of acute hypoxia and its interactions with esketamine. We provide a summary of the effects of hypoxia and esketamine on the neurocircuitry that leads to arousal, activation of the sympathetic nerve system, and increased drive to upper airway dilator and respiratory pump muscles.

中文翻译：

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缺氧和艾氯胺酮对呼吸、交感神经系统和皮质功能的神经解剖学和药物生理学影响。


急性缺氧通气反应是一种重要的反射，有助于在低氧水平下维持呼吸，但大多数全身麻醉都会减弱。已知氯胺酮和艾氯胺酮的镇痛剂量具有呼吸兴奋作用。在他们最近发表在《英国麻醉杂志》上的研究中，Jansen 及其同事表明，低剂量艾氯胺酮保留了急性缺氧通气反应，同时增加了呼吸频率、收缩压和心率。与对照组相比，参与者还表现出更高水平的警觉性和令人不快的精神作用。我们回顾了急性缺氧的药理学效应及其与艾氯胺酮的相互作用。我们总结了缺氧和艾氯胺酮对神经回路的影响，这些神经回路导致觉醒、交感神经系统的激活以及对上气道扩张器和呼吸泵肌的驱动力增加。