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19期1696-1698,共3页Chinese Journal of Hospital Pharmacy

摘　　要：目的：比较丁丙诺啡与氟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 patient-eontrolled 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 ketamine ＋ droperidol ＋ bupivacaine （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 observed. 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 incidence 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]