摘要
目的观察低剂量氯胺酮超前镇痛对上腹部手术后自控镇痛效果的影响。方法 60例择期上腹部手术患者,按随机数字表法分为3组,氯胺酮1组切皮前5 min静脉滴注氯胺酮0.15 mg/kg,后持续泵注氯胺酮0.2 mg/(kg.h)至手术结束;氯胺酮2组切皮前5 min静脉滴注氯胺酮0.3 mg/kg,后持续泵注氯胺酮0.4 mg/(kg.h)至手术结束;对照组相应静脉滴注和泵注生理盐水。分别于术后6(T1)、12(T2)、24(T3)、48(T4)、72 h(T5)观察患者的镇痛效果。结果患者清醒时间、拔管时间三组比较差异无统计学意义(P>0.05);苏醒期不良反应发生情况三组差异无统计学意义(P>0.05)。与对照组比较,术后氯胺酮1组和氯胺酮2组各时间点VAS评分明显降低(P<0.05或P<0.01);而氯胺酮1组和氯胺酮2组间比较差异无统计学意义(P>0.05)。结论排除氯胺酮禁忌证,全身麻醉下行上腹部手术给予低剂量氯胺酮,能改善术后自控镇痛的效果,具有超前镇痛的作用。
Objective To evaluate the effects of preemptive intravenous injection low-dose of ketamine on postoperative analgesia. Methods Sixty patients underwent upper abdominal surgery were randomly divided into 3 groups：control group, ketamine 1 group and ketamine 2 group. The ketamine 1 group was given ketamine 0. 15 mg/kg i. v. 5 min before skin incision and 0. 2 mg/kg.h for maintenance during operation. The ketamine 2 group was given ketamine 0. 3 mg/kg i. v and 0. 4 mg/kg. h for maintenance. The control group was given equal volume of normal saline. All patients received postoperative PCIA. Visual analogue scale （VAS） scores at rest and movement were assessed within postoperative 72 hours. Results The VAS scores of the ketamine 1 group and ketamine 2 group were significantly lower than that of the control group at all time point （ all P 〈 0. 05 ）. However, there was no statistically signifi- cant difference of VAS scores between the two ketamine groups （P 〉 0. 05）. Conclusions After eliminating ketamine contraindications, the preemptive intravenous injection of low-dose of ketamine can improve the effect of postoperative controlled analgesia for pa- tients underwent upper abdominal surgery under general anesthesia.
出处
《实用医院临床杂志》
2013年第4期147-149,共3页
Practical Journal of Clinical Medicine
基金
四川省卫生厅科研基金资助项目(编号:090055)
关键词
超前镇痛
氯胺酮
术后镇痛
Preemptive analgesia
Ketamine
Postoperative analgesia
