摘要
目的评估硬膜外腔注入氯胺酮进行超前镇痛用于全膝关节置换术后镇痛效果.方法 30例单侧全膝关节置换术病人随机分为两组:Ⅰ组15例,氯胺酮0.5 mg/kg +生理盐水稀释成6 ml麻醉前硬膜外腔注入;Ⅱ组(对照组)15例,麻醉前硬膜外腔生理盐水6 ml注入.观察两组病人术后镇痛效果、并发症的发生.结果Ⅰ组12例术后无痛(VAS 0～1分)占80.0%,Ⅱ组5例占33.3%,两组比较差异非常显著(P＜0.01),术后VAS评分Ⅰ组明显低于Ⅱ组(P＜0.01).呼吸抑制、头痛、恶心呕吐、皮肤瘙痒、幻觉等副反应差异无显著性(P＞0.05).结论硬膜外腔注入氯胺酮进行超前镇痛可降低创伤导致的疼痛致敏作用,镇痛效果优于单独使用布匹卡因,更有利于术后恢复.
Objective To investigate the post-operative analgesic effects of ketamine in patients undergoing total knee replacement surgery. Methods 30 adult patients （ASAⅠ-Ⅱ ） undergoing total knee replacement surgery were randomly divided into two groups： group Ⅰ and group Ⅱ . Group Ⅰ received epidural postoperative analgesia with ketamine 30mg. Group Ⅱ received epidural postoperative analgesia with 6ml normal saline. All the patients maintained analgesia for 2 days. VAS pain scores and complications were observed and assessed. Results There were 12 painless patients （80%） in group Ⅰ and 5 painless patients （33.3%） in group Ⅱ ,there was a significant difference between two groups （ P〈0.01 ）. The postoperative VAS scores in group Ⅰ were obviously lower than those in group Ⅱ （ P〈0.01）, however, there were no significant differences in the incidences of nausea, vomiting and exhausting time between two groups （ P〉0.05）. Conclusion The postoperative analgesic effects of ketamine in patients undergoing total knee replacement surgery can reduce pain scores and produce better postoperative analgesia effects, with the decrease of incidence of complication, which is superior to simple bupivaeaine and is beneficial to patients＇ recovery after operation.
出处
《河北医药》
CAS
2005年第8期579-580,共2页
Hebei Medical Journal
关键词
硬膜外腔注射
全膝关节置换术
氟胺酮
镇痛超前
术后
epidural injection
total knee replacement
ketamine
postoperative analgesia
postoperation
