摘要
为观察芬太尼、氟胺酮在硬膜外/蛛网膜下腔麻醉中的临床效果,将80例择期行子宫手术的病人随机分成4组(每组20例):蛛网膜下腔分别加入10%葡萄糖溶液(C组)、芬太尼20μg(F组)、氯胺酮10mg(K组)或芬太尼20μg+氯胺酮10mg(F+K组)。在脊麻后及术中记录血压、心率、麻醉平面及牵拉反应情况;比较各组麻醉起效时间(Ti)及维持时间(Tm)。术终请外科医师和病人对麻醉情况进行评分。结果:K组Ti明显延长,但Tm与C组无明显变化;F组和F+K组的Tm明显延长,且F+K组牵拉反应发生率较C组明显降低(P<0.05)。外科医师和病人对麻醉评分各组无明显差异。结论:硬膜外/蛛网膜下腔麻醉中伍用芬太尼或芬太尼和氯胺酮合剂可明显延长麻醉维持时间,而且后者能更好地防止术中牵拉反应的发生。
Objective: To observe the application of fentanyl and ketamine in combined spinal and epidural anesthesia. Methods: Eighty patients undergoing selective abdominal hysterectomy were assigned to one of four groups to receive 15 mg bupivacaine plus following drugs intrathecally.Group C received 10% glucose; Group F 20 microg fentanyl; Group K 10 mg ketamine; Group F+ K 20 fig fentanyl plus 10 mg ketamine. BP, HR, sensory block level and the incidence of referred pain were recorded after spinal injection and during operation. The onset (Ti)and the duration of action (Tm) of anesthesia were also noted. Anesthesia was assessed by surgeons and visual analogy scale (VAS) was assessed by patients . Results: In group K, Ti was significantly prolonged (P < 0.05 ) while Tm showed little change. Tm in both group F and group K + F were remarkably prolonged , and incidence of referred pain in group F+ K decreased significantly (P<0.05). The assessments of surgeons and patients showed no significant differences. Conclusion: The application of fentanyl or fentany plus detamine may prolong the duration of action , and the latter may inhibit the intraoperative referred pain better.
出处
《医学理论与实践》
2000年第12期722-723,共2页
The Journal of Medical Theory and Practice
关键词
硬膜外
蛛网膜下腔
麻醉
芬太尼
氯胺酮
Anesthesia, Combined spinal and epidural, Fentanyl, Ketamine
