氯胺酮联合吗啡、可乐定用于晚期癌痛患者硬膜外自控镇痛  

Application of Ketamine Combined Morphine,Clonidine on Patient-controlled Epidural Analgesia in Patients with Terminal Cancer Pain

作　　者：王燕[1] 李清[1] 秦成名[1] 刘菊英[1] 

机构地区：[1]郧阳医学院附属太和医院麻醉科,湖北十堰442000

出　　处：《湖北医药学院学报》2009年第5期466-468,共3页Journal of Hubei University of Medicine

摘　　要：目的:探讨吗啡+氯胺酮+可乐定对晚期癌痛的自控镇痛效果。方法:60例三阶梯疗法欠佳的晚期癌症疼痛病人随机均分4组,分别配制吗啡、吗啡+氯胺酮、吗啡+可乐定、吗啡+氯胺酮+可乐定镇痛液进行硬膜外自控镇痛(PCEA),记录第1、3、6、10、15、17、20 d的视觉模拟评分(VAS),测量血压、脉搏、氧饱和度,并用汉密顿抑郁量表(HAMD)进行治疗前后的抑郁情绪评估,记录恶心、呕吐、尿潴留、皮肤瘙痒、呼吸抑制等并发症。结果:吗啡+氯胺酮+可乐定组VAS评分和HAMD评分均较其他3组低、不良反应次数最少。结论:吗啡+氯胺酮+可乐定用于晚期癌症镇痛效果好,副作用少,安全性高。Objective To investigate the efficacy of ketamine combined morphine,clonidine on patient-controlled epidural analgesia in patients with terminal cancer pain.Methods Sixty terminal cancer pain patients that poorly controlled with three-step analgesic ladder were randomly divided into four groups:morphine group,morphine+ketamine group,morphine+clonidine group,morphine+ketamine+clonidine group.The visual analogue score(VAS) was respectively recorded at d 1,d 3,d 6,d 10,d 15,d 17 and d 20,the blood pressure,pulse,oxygen degree of saturation(SPO 2) were recorded,Hamilton rating scale for depression(HAMD) were evaluated before and after the treatment,the complications of the nausea and vomitting,uroschesis,itch of skin,respiratory depression were also observed.Results The VAS and HAMD value in morphine+ketamine+clonidine group were all lower than the other three groups,and the frequency of complication in this group was also least.Conclusion Ketamine combined morphine,clonidine may be a effective,less complication and safe method for patient-controlled epidural analgesia in patients with terminal cancer pain.

关 键 词：吗啡 氯胺酮 可乐定 晚期癌痛 硬膜外自控镇痛术 

分 类 号：R730.5[医药卫生—肿瘤]