摘要
目的:观察小剂量氯胺酮复合舒芬太尼连续臂丛神经阻滞在上肢创伤后疼痛患者中的应用。方法:选择上肢创伤后严重疼痛患者19例,采用连续臂丛神经阻滞病人自控镇痛。药物配方为氯胺酮0.5mg/ml+舒芬太尼0.5μg/ml+左旋布比卡因1.25mg/ml,镇痛泵中药物均用生理盐水稀释至150ml,48h后停止使用镇痛泵。观察患者连续臂丛神经阻滞镇痛前、镇痛后2h、12h、24h、48h、72h的镇痛评分、镇静评分以及恶心呕吐、皮肤瘙痒、幻觉等发生情况。结果:与镇痛前相比,镇痛后各时段镇痛评分均显著性降低(P<0.05,P<0.01),镇静评分无明显变化(P>0.05)。在整个观察期间,所有患者均无恶心呕吐、皮肤瘙痒和幻觉等副作用的发生。结论:小剂量氯胺酮复合舒芬太尼连续臂丛神经阻滞在上肢创伤后疼痛患者中具有良好的镇痛作用,而无明显副作用。
Objective：To investigate the application of small-dose ketamine combined with sufentanil for continuous brachial plexus block in patients of upper limbs trauma pain.Methods：Nineteen patients with upper limbs trauma pain received continuous brachial plesus block with combination of 0.5mg/ml ketamine,0.5μg/ml sufentanil ,and 1.25mg/ml levobupivacaine for patient controlled analygesia（PCA）.The drugs used were diluted in 150ml normal saline.For analgesia administration,an experiment dose（2% lidocaine 5ml）was giver followed by a background infusion （2.0ml/h）,with patient-controlled bolus doses of 1.0ml with lock-out time of 15 min via PCA pump for 48h.The visual analogue scale （VAS）,sedation score and incidences of nausea,vomitin,pruritus and hallucinations were recorded before and 2h,12h,24h,48h,72h after the analgesia.Results：Compared with before the analgesia,the VAS pain scores were decreased signifcantly in 2h,12h,24h,48h,72h after the analgesia （P〈0.05,P〈0.01）,respectively.But the sedative scores were similar before and after the analgesia （P〉0.05）.There was neither nausea,vomiting,pruritus nor hallucinations was reported during the 72h.Conclusion：Small-dose ketamine combined with sufentanil for continuous brachial plexus block have obviously analgesic effect in patients with upper limbs trauma pain and no side effect.
出处
《中国医药导刊》
2008年第8期1186-1187,共2页
Chinese Journal of Medicinal Guide
关键词
氯胺酮
舒芬太尼
疼痛
创伤
神经阻滞
臂丛
病人自控镇痛
Ketamine
sufentanil
pain,trauma
nerve block,brachial plexus
patient controlled analgesia
