摘要
目的观察硬膜外给予小剂量氯胺酮超前镇痛结合术后镇痛对炎性反应的影响。方法80例上腹部手术患者随机分为四组,麻醉方式为全麻联合硬膜外麻醉。A组(n=20)患者手术前硬膜外注射氯胺酮0.5 mg/kg,B组(n=20)患者术后48小时给予0.2%罗哌卡因持续硬膜外镇痛(PCEA),C组(n=20)术前硬膜外注射氯胺酮0.5 mg/kg,术后48小时给予0.2%罗哌卡因持硬膜外镇痛,D组为对照组(n=20)。采集所有患者动脉血4 ml,测量患者术后8、244、8、72小时4个时间点C反应蛋白(CRP)、白介素-6(IL-6)值。结果四组患者CPRI、L-6术后第一天显著上升并达到峰值,48小时后开始下降,C组上升幅度最小,与其他三组相比有显著差别(P<0.05)。结论氯胺酮硬膜外超前镇痛结合PCEA可有效抑制术后炎性反应。
Objective To observe the efect of preemptive analgesia with Ketamine epidural injection pre-operafion combined PCEA on inflammatory response, Methods eighty hundred patients （ASA Ⅰ-Ⅱ ） undergoing epigastric operation were randomly divided into four groups：group A（ n = 20）were injected ketamine 0.5 mg/kg into epidural cavity before operation;Group B（ n = 20）received PCEA with 0.2% ropivacaine after operation; Group C（ n = 20）received both of ketarnine 0,5 mg/kg as preemptive analgesia and PCEA with 0,2% ropivacaine after operation. As a control,there was no special administration to group D before or after operation. Results There was increase of CPR and IL-6 level in all groups,but the increased level in group C is much lower （P 〈 0.0.5）, Conclusion Preemptive analgesia with Ketamine epidural injection pre-operation combined PCEA decreased postoperative inflammatory response.
出处
《中国实验诊断学》
2008年第6期767-768,共2页
Chinese Journal of Laboratory Diagnosis
关键词
氯胺酮
超前镇痛
炎性反应
PCEA
ketamine
preemptive analgesia
inflammatory response
PCEA
