氯胺酮对剖宫产围术期产妇镇痛及认知功能影响  

EFFECT OF KETAMINE ON PERIOPERATIVE ANALGESIA AND COGNITIVE FUNCTION IN PARTURIENTS UNDERGOING CESAREAN SECTION

作　　者：崔珊珊[1] 刘英志[2] 王世端[2] 张晓[2] 

机构地区：[1]青岛大学医学院,山东青岛266021 [2]青岛大学医学院附属医院

出　　处：《青岛大学医学院学报》2013年第2期168-170,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：目的了解小剂量氯胺酮对剖宫产产妇围术期镇痛及认知功能的影响。方法择期剖宫产产妇60例,年龄20～36岁,术前简易智力量表(MMSE)评分>27分,随机分为两组,各30例。小剂量氯胺酮组(K组)硬膜外阻滞完善后、切皮前1min静脉注射氯胺酮0.4mg/kg,对照组(C组)硬膜外阻滞完善后、切皮前1min静脉注射等容量生理盐水。观察两组产妇术中反应,并于术后2、6、24h进行疼痛视觉模拟(VAS)评分和MMSE评分。结果 K组产妇娩胎时喊叫与呻吟的发生率明显低于C组(χ2=10.951,P<0.05)。K组术后2h的VAS评分低于C组(t=-2.074,P<0.05),其余时点两组VAS评分差异无显著性(P>0.05)。两组产妇术后各时点的MMSE评分差异均无统计学意义(P>0.05)。K组和C组的麻醉满意度差异无显著性(P>0.05)。结论小剂量氯胺酮辅助硬膜外麻醉用于剖宫产手术围术期镇痛效果好,不良反应少,不会影响术后认知功能。Objective To study the effect of low-dose ketamine on perioperative pain and cognitive function in lying in women receiving cesarean section. Methods Sixty pregnant women aged 20 to 36, preoperative MMSE score ）〉27 ruarks, scheduled for cesarean section were equally randomized to two groups： low-dose ketamine group and control group. Upon comple tion of epidural block, and before starting surgery, intravenous ketamine （0.4 mg/kg） was given to women in ketamine group, and equivalent volume of normal saline given to those in the control. Intraoperative reactions of lying in women in both groups were ob- served, VAS and MMSE scoring were carried out 2, 5 and 24 h after surgery. Results The incidence of crying and groaning was much lower in women in ketamine group than those in the control （x2 = 10.951 ,P〈0.05）. The VAS score at 2h after operation in ketamine group was lower than that in the control （t= 2.074,X2=10.951,P〈0.05） , but the differences of that between the rest time points were not significant. There were no significant differences between the two groups in terms of postoperative MMSE score and degree of satisfaction with anesthesia （P〉0.05）. Conclusion Low-dose ketamine-assisted epidural anesthesia is effec tire for perioperative analgesia of cesarean section with few adverse reactions, which does not affect postoperative cognitive func tion.

关 键 词：氯胺酮 麻醉 硬膜外 剖宫产术 认知障碍 镇痛 产科 

分 类 号：R614[医药卫生—麻醉学]