布托啡诺复合小剂量氯氨酮用于剖宫产术后镇痛  

Postoperative analgesia of cesarean section by buprenorphine hydrochloride combined with low ketamine

作　　者：张勇 邓燕[2] 

机构地区：[1]山东省枣庄市王开传染病医院,277500 [2]山东省滕州市中心人民医院

出　　处：《中国实用医刊》2010年第17期6-7,共2页Chinese Journal of Practical Medicine

摘　　要：目的 观察术后硬膜外持续泵入布托啡诺复合小剂量氯胺酮用于剖宫产术后镇痛的效果和对初乳及不良反应的影响. 方法选择40例Ⅰ～Ⅱ级择期或急症孕足月行剖宫产手术后的产妇,年龄23～35岁,随机分为两组.A组为观察组(n=20),用布托啡诺0.1 mg/kg+氯胺酮1 mg/kg+生理盐水至 100 ml持续泵入;B组为对照组(n=20),用0.15%罗哌卡因+0.004%芬太尼+0.1%地塞米松+生理盐水总量100 ml持续泵入.观察产妇术后各时间段的视觉模拟镇痛评分(VAS)、镇静评分、泌乳时间,并对术后产妇的总体感觉满意度进行评分.结果 A、B两组在泵药后4、12、24、48 h的VAS评分、镇静评分差异无统计学意义(P>0.05).A组产妇的总体感觉满意度高于B组(P<0.05),两组的初乳时间差异无统计学意义(P>0.05).结论 布托啡诺复合小剂量氯胺酮硬膜外持续泵入用于剖宫产术后镇痛可以提供满意的镇痛效果,而且也有利于术后产妇的恢复,并且不影响泌乳.Objective To observe the analgesia effects of buprenorphine hydrochloride combined with low ketamine that continued to pump into epidural space,which were used to treat postoperative analgesia of cesarean section and to study their on colostrums and side reactions. Methods Forty patients were at age of 23-35 years and term pregnancy, who were 1-2 grade or emergency.These cases were randomly divided into two groups: group A(study group,n=20) and group B(control group,n=20),group A were treated with buprenorphine hydrochloride(0.1 mg/kg)+ ketamine(1 mg/kg)+NS(coming to 100 ml),which continued to pump into epidural space. Group B were treated with ropivacaine(0.15%)+febtanyl citrate(0.004%)+dexame thasone(0.1%)(coming to 100 ml), which continued to pump into epidural space.We observe postoperative parturients mimic analgesia VAS of visual sense,sedation VAS,lactigenous time and the total degree of satisfaction. Results There were no significant difference between group A and group B about mimic analgesia VAS of visual sense(P>0.05) and lactigenous time(P>0.05),the total degree of satisfaction in group A was higher than that in group B (P<0.05). Conclusions Buprenorphine hydrochloride combined with low ketamine continued to pump into epidural space,which are used to treat postoperative analgesia of cesarean section, show satisfactory analgesia effect, and it is propitious to recovery of posteroprative parturients and did not influence lactation.

关 键 词：割官产 术后镇痛 布托啡诺 氯胺酮 

分 类 号：R614[医药卫生—麻醉学]