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华西医学  2010 

氯胺酮超前镇痛预防瑞芬太尼麻醉后急性疼痛的临床研究

, PP. 1523-1524

Keywords: 氯胺酮,超前镇痛,瑞芬太尼,急性疼痛

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Abstract:

【】目的观察在腹腔镜胆囊切除术中,氯胺酮超前镇痛对瑞芬太尼麻醉后急性疼痛的影响。方法2009年10月-2010年1月,将择期行腹腔镜胆囊切除术患者90例,随机分为对照组(C组)、氯胺酮超前镇痛组(K组)、氯胺酮术毕镇痛组(K1组),每组30例。所有患者均采用瑞芬太尼复合丙泊酚静脉麻醉,K组在切皮前静脉给予氯胺酮0.5mg/kg,K1组在关腹前静脉给予氯胺酮0.5mg/kg,C组不给予任何药物。记录术毕患者麻醉恢复情况,各时间点疼痛程度。结果K组、K1组躁动发生率均明显低于C组(P<0.05);术后2、4、8、24h,K组VAS评分及镇痛药使用率明显低于C组和K1组(P<0.05)。结论氯胺酮超前镇痛能明显降低瑞芬太尼术后疼痛,并且不增加并发症发生率。?【Abstract】ObjectiveToevaluatethepreemptiveanalgesiaofketamineonremifentanilinducedacutepostoperativepainafterlaparoscopiccholecystectomy.MethodsNintypatientsscheduledforlaparoscopiccholecystectomybetweenoctober2009toJannary2010wererandomlyassignedtothreegroups(n=30).GroupKwasadministratedwith0.5mg/kgketamineintravenouslybeforeskinincision,andGroupK1wereadministratedwith0.5mg/kgketamineintravenouslybeforeabdominalclosure,whileGroupCreceivednothing.Therecoveryandthesideeffectswererecorded,theVASattwo,four,eightand24hoursaftersurgery,andtheuseofanodynewererecorded.ResultsTheincidenceofrestlessnessinGroupsKandK1wasremarkablylowerthanthatofGroupC(P<0.05).Theanalgesiceffectstwo,four,eightand24hoursaftersurgerywereobviouslybetteringroupKthanthoseofGroupCandGroupK1(P<0.05).ConclusionKetaminecanproducepreemptiveanalgesiatorelieveremifentanil-inducedacutepain,anditwouldnotincreaseincidenceofsideeffects.

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