低剂量氯胺酮治疗慢性神经痛的临床观察  

Clinical observation of treatment of chronic neuropathic pain with low-dose ketamine

作　　者：杨云丽[1] 魏辉明[1] 于涛[1] 

机构地区：[1]成都军区昆明总医院麻醉科,昆明650032

出　　处：《西南国防医药》2011年第8期861-863,共3页Medical Journal of National Defending Forces in Southwest China

摘　　要：目的观察低剂量氯胺酮对慢性神经痛患者的镇痛作用。方法选择慢性顽固性神经痛患者11例,于疼痛缓解期静注氯胺酮0.1 mg/kg后,持续静脉输注氯胺酮6μg/(kg.min),连续4 d。如果患者疼痛消失或显著减轻,则停止输注;反之如果患者自觉疼痛程度又恢复至输注前水平时,再次给药,方法、剂量同前。分别于每次输注前、输注24、48、72、96 h及输注后每周1次、4 w后每月1次随访,以视觉模拟评分(VAS)评估疼痛程度;输注期间观察不良反应及血氧饱和度变化。结果 11例均进行了至少2次输注,8例3次。第1次与第2次输注平均间隔4.2 w,第2次与第3次间隔6.9个月。输注氯胺酮后,VAS及触诱发痛与输注前比较显著改善(P<0.05)。输注期间血氧饱和度无显著变化(P>0.05),输注期间不良反应少。结论持续静脉输注低剂量氯胺酮对慢性顽固性神经痛患者有效、安全,不良反应轻。Objective To observe the analgesic effect of low-dose ketamine on chronic neuropathic pain.Methods 11 selected patients with chronic refractory neuropathic pain were intravenously injected with ketamine at 0.1 mg/kg during pain relief followed by continuous intravenous infusion of ketamine at 6 μg /（kg·min） for 4 successive days.If the pain disappeared or alleviated,the infusion would stop;if it recovered to the level before infusion,the same usage and dosage of ketamine as described above would be administered again.Visual analogue score（VAS） and tactile allodynia were recorded before infusion,at 24,48,72,96 h during infusion,once a week after infusion,and once a month after 4 w.In addition,adverse reactions and blood oxygen saturation were observed during infusion.Results All the patients were infused at least twice,and 8 patients three times.The average interval between the first and second infusion was 4.2 w,and that between the second and third infusion was 6.9 months.The VAS and tactile allodynia were significantly improved after the infusion compared with pre-infusion（P0.05）.No significant change of blood oxygen saturation was found and the side effects were slight during the infusion.Conclusion Continuous intravenous infusion of low-dose ketamine is effective and safe for patients with chronic refractory neuropathic pain.

关 键 词：氯胺酮 神经痛 低剂量 

分 类 号：R441.1[医药卫生—诊断学]