小剂量氯胺酮硬膜外腔自控镇痛用于双侧臀肌挛缩松解术后镇痛研究  

Study on Patient Controlled Epidural Analgesia with Low-dose Ketamine for Postoperative Analgesia of Bilateral Gluteal Muscle Contracture Lysis

作　　者：李水英[1] 周红梅[1] 崔秀联[1] 

机构地区：[1]佛山市南海区第二人民医院麻醉科,广东佛山528251

出　　处：《医学综述》2015年第5期907-909,共3页Medical Recapitulate

摘　　要：目的探讨小剂量氯胺酮硬膜外腔自控镇痛(PCEA)用于双侧臀肌挛缩松解术后镇痛的效果。方法选择2011年8月至2013年8月南海区第二人民医院收治的在腰硬联合麻醉下行双侧臀肌挛缩松解术的患者90例,根据术后不同的治疗方法分为3组,各30例,观察组术后保留硬膜外腔导管,行小剂量氯胺酮PCEA;对照1组术后保留硬膜外腔导管行吗啡PCEA;对照2组术后拔除硬膜外腔导管行酮咯酸氨丁三醇持续静脉镇痛(PCIA)。采用疼痛视觉模拟评分法(VAS)评价3组的镇痛效果,比较3组不良反应。结果 3组镇痛效果VAS的评价差异无统计学意义(P>0.05);3组患者镇痛期间生命体征均无显著变化,基本保持平稳(P>0.05);对照2组不良反应发生率显著高于对照1组(P<0.05),对照1组和对照2组的不良反应发生率均高于观察组(P<0.05)。结论双侧臀肌挛缩松解术后采用小剂量氯胺酮PCEA的镇痛效果较理想。Objective To investigate the efficacy of the patient controlled epidural analgesia （ PCEA） with low-dose ketamine for postoperative analgesia of bilateral gluteal muscle contracture lysis .Methods A total of 90 patients underwent epidural anesthesia for bilateral gluteal muscle contracture lysis in Nanhai Sec-ond People′s Hospital from Aug.2011 to Aug.2013 were randomly divided into three groups,with 30 cases in each group.Patients in the observation group were treated with PCEA by giving small doses of ketamine through epidural tube after operation.Patients in control group 1 were treated with PCEA by giving morphine through epidural tube after operation,and patients in control group 2 were treated with patient controlled in-travenous analgesia（ PCIA） by giving ketorolac tromethamine after removal of the epidural tube .Visual ana-log scale （VAS） was used to evaluate the analgesic effect of the three groups,differences of adverse reactions were also compared.Results There were no statistically significant differences of VAS evaluation on analge-sic effect among the three groups（P〉0.05）.There were no significant changes to vital signs of the patients in three groups（P〉0.05）.Cases of adverse reactions in control group 2 were significantly more than control group 1（P〈0.05）;and cases of adverse reactions in control group 1 and 2 were more than the observation group （P〈0.05）.Conclusion The analgesic effect of PCEA with small dose of ketamine for postoperative analgesia of bilateral gluteal muscle contracture lysis is ideal.

关 键 词：双侧臀肌挛缩松解术 小剂量 镇痛效果 氯胺酮 硬膜外腔自控镇痛 

分 类 号：R602[医药卫生—外科学]