亚麻醉剂量氯胺酮对雷米芬太尼麻醉术后镇痛的影响  

Effects of subanesthetic dose of ketamine on the pain after remifentanil

作　　者：赵峰[1] 季淑娟[1] 朱阿立[1] 崔苏扬[1] 

机构地区：[1]南京中医药大学附属医院麻醉科,210029

出　　处：《临床麻醉学杂志》2008年第10期853-855,共3页Journal of Clinical Anesthesiology

摘　　要：目的研究术中持续输注亚麻醉剂量氯胺酮对雷米芬太尼麻醉术后镇痛的影响。方法择期行胃癌根治术患者40例,随机均分为亚麻醉剂量氯胺酮复合雷米芬太尼组(研究组)和单纯雷米芬太尼组(对照组)。两组均接受雷米芬太尼1μg/kg诱导和0.5μg·kg-1·min-1持续输注;研究组加用氯胺酮0.15 mg/kg诱导和2μg·kg-1·min-1术中持续输注。记录术后患者清醒和拔管时间,气管拔管即刻、术后6、12、24、36和48 h的视觉模拟评分(VAS)、镇静评分、气管拔管前的躁动次数和患者自控镇痛(PCA)总次数。结果研究组患者气管拔管即刻、术后6、12、24、36和48 h的VAS和PCA总次数显著低于对照组(P<0.05或P<0.01),清醒和拔管时间、躁动次数以及镇静评分差异无统计学意义。结论术中持续输注亚麻醉剂量氯胺酮能显著降低雷米芬太尼麻醉术后VAS,减少患者PCA次数,提高患者镇痛满意度。Objective To evaluate the effect of subanesthetic dose of ketamine on the pain after remifentanil. Methods Forty cases undergoing radical operation for gastric cancer were randomized into remifentanil combined subanesthetie dose of ketamine group （study group） and remifentanil group （control group）. The patients in both groups received remifentanil 1 μg/kg for induction and 0.5μg·kg^-1·min^-1 for maintenance. The patients in study group was given additional ketamine 0. 15 mg/kg for induction and 2 μg·kg^-1·min^-1 for maintenance during operation. The time of consciousness recovery and extubation, VAS and sedation scores and PCA numbers were recorded at 0,6,12,24,36 and 48 h after operation. Results VAS scores and PCA numbers during postoperative analgesia were all less in study group than those in control group （P〈0.05）. There were no significant differences in sedation score and the time of consciousness recovery and extubation between the two groups. Conclusion Continuous infusion of subanesthetie dose of ketamine may significantly reduce VAS scores and PCA numbers and improve analgesia satisfaction in the patients after stopping remifentanil anesthesia.

关 键 词：氯胺酮 雷米芬太尼 术后镇痛 

分 类 号：R614[医药卫生—麻醉学]