丁丙诺啡与氯胺酮应用于术后硬膜外镇痛的临床比较  

Clinical analysis of buprenorphine and ketamine used in postoperation

作　　者：刘建芳[1] 成之福[1] 辛本茹[1] 徐丽[1] 

机构地区：[1]日照市人民医院,山东日照276826

出　　处：《中国医院药学杂志》2008年第18期1583-1585,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的:比较丁丙诺啡与氯胺酮应用于硬膜外腔自控镇痛(PCEA)的镇痛效果与不良反应。方法:选择腰硬联合麻醉下行下腹部择期手术、ASAⅠ-Ⅱ级的患者60例。随机双盲分为丁丙诺啡+氟哌利多(A组)、丁丙诺啡+氟哌利多+布比卡因;(B组)、氯胺酮+氟哌利多+布比卡因(C组)。观察0～48h内各时段追加次数,视觉模拟评分(VAS),镇静评分(Ramsay评分),肠功能恢复时间及恶心呕吐等不良反应。结果:各时段追加次数、VAS、Ramsay评分,A组与B、C组比较差异有显著性(P<0.05);肠功能恢复时间,A与C、B组比较差异有显著性(P<0.05);恶心呕吐、皮肤瘙痒、尿潴留发生率各组间比较差异均有极显著性(P<0.01)。结论:丁丙诺啡、氯胺酮复合局麻药行PCEA的镇痛效果确切;氯胺酮组在减低恶心呕吐、皮肤瘙痒、尿潴留发生率方面显示明显优越性。OBJECtIVE To compare the analgesic effect and the adverse reactions of buprenorphine and ketamine used in pa- tient controlled intravenous analgesia （PCEA）. METHODS The experimental objects were 60 cases of patients who received the lower abdomen optional surgery under Epidural anesthesia, （ASA Ⅰ-Ⅱ ） and using the random and double-blind method they were divided into buprenorphine ＋ droperidol （group A）, buprenorphine ＋ droperidol ＋ bupivacaine （group B） ,and ket amine ＋ droperidol ＋ bupivaeaine （group C）. The additional number within 0 - 48 hours, visual analog score （VAS）, sedation score （Ramsay score）, the recovery time of intestinal function and some adverse reactions such as nausea and vomiting were ob- served. RESULTS The additional number in each period, VAS and Ramsay score were significantly different among Group A ,B and C （P〈0. 05） ; recovery time of intestinal function between Group A and B, C had a significant difference （P〈0. 05） ; and in the aspects of the incidence rate of nausea and vomiting, itch of skin, and urinary retention, there was also a significant difference among each group （P〈0. 01）. CONCLUSION The analgesic effect of PCEA under local compound anesthetics of buprenorphine and ketamine is certain ; and the ketamine group shows a clear superiority in the aspects of reducing the inci dence rate of nausea and vomiting, itch of skin, and urinary retention.

关 键 词：丁丙诺啡 氯胺酮 硬膜外腔 镇痛 

分 类 号：R978[医药卫生—药品]