摘要
目的 :研究氯胺酮对罗哌卡因硬膜外镇痛效应的影响。方法 :60例下腹部手术患者随机分为治疗组和对照组各 3 0例 ,两组患者手术完毕后 ,施行患者自控硬膜外镇痛 (PCEA)。对照组经硬膜外导管注入 0 .2 %罗哌卡因加0 .0 0 0 2 %芬太尼镇痛混合液负荷剂量 5mL ,每隔 15min ,若无明显镇痛效应 ,给予剂量 3mL ,维持剂量 2mL·h 1 ,维持2 4～ 48h。治疗组进行PCEA前 1h给予硬膜外导管注入氯胺酮 0 .3mg·kg 1 ,其他方法同对照组。记录术后 2 4h内的疼痛评分 (VAS) ,评价镇痛效果 ;舒适评分 (BCS)判断患者舒适程度。结果 :对照组VAS评分明显高于治疗组 ,BCS评分明显低于治疗组 ,均差异有显著性 (均P <0 .0 5 )。结论 :硬膜外预先注入氯胺酮可增强罗哌卡因的镇痛作用。
Objective:To study the influence of pretreatment with ketamine on the epidural analgesic effect of ropivacaine. Methods:60 ASAⅠ-Ⅱpatients scheduled for elective hypogastric surgeries were randomly divided into 2 equal groups,the control group(A) and ketamine group(B). After the surgeries,patients of both groups were subjected to PCEA (patient controlled epidural analgesia). In this procedure,patients of group(A) were given each 5 mL of 0.2% ropivacaine with addition of 0.0002% fentanyl analgesic mixture administered through an epidural catheter. Another 3 mL of the drug were injected 15 min later if no apparent analgesic effect was induced. Thereafter,a maintenance dose of 2 mL·h -1 was sustained for 24～48 h. 1 h before PCEA,patients of group (B) were given each 0.3 mg·kg -1 of ketamine administered through the epidural catheter. All other measures were the same as those taken for patients of group(A). Visual analogue scale(VAS) score and Bruggerman comfort scale (BCS) score were registered 4,8,16 and 24 h after the operation to assess the analgesic effect and the level of comfortableness,respectively. Results:The VAS scores in group (B) were significantly lower than those in group (A),while the BCS scores in group(A) were significantly lower than those in group(B) ( P <0.05 in both cases). Conclusion:Pretreatment with ketamine was shown to enhance the analgesic effect of ropivacaine.
出处
《医药导报》
CAS
2004年第8期549-551,共3页
Herald of Medicine
