氯胺酮对瑞芬太尼引起的甲状腺手术患者术后痛觉过敏的影响  

Effects of ketamine on remifentanil-induced postoperative hyperalgesia in patients undergoing thyroid surgery

作　　者：阮加萍[1] 陈晏 王兰兰 孙运乾[1] 茆庆洪[1] Ruan Jiaping;Chen Yan;Wang Lanlan;Sun Yunqian;Mao Qinghong(Department of Anesthesiology, the Affiliated Hospital of Inte grated Traditional Chinese and Western Medicine, Nanjing University ofChinese Medicine, Jiangsu Province Academy of Traditional Chinese Medicine, Nanjing 210028, China)

机构地区：[1]南京中医药大学附属中西医结合医院,江苏省中医药研究院麻醉科,南京210028

出　　处：《国际麻醉学与复苏杂志》2019年第4期298-301,共4页International Journal of Anesthesiology and Resuscitation

基　　金：中国中医科学院中央公益性研究基金项目(ZZ08080013);中国中医科学院江苏分院院级项目(JSBN1302).

摘　　要：目的探讨同时输注氯胺酮对甲状腺手术患者术中使用瑞芬太尼引起的痛觉过敏的影响。 方法选择拟在全身麻醉下行择期甲状腺手术的患者40例。采用随机数字表法分为两组(每组20例):氯胺酮组、生理盐水对照组。用von Frey细丝测定患者术后24、48 h的疼痛阈值,采用数字评定量表(Numeric Rating Scale, NRS)对术后30 min、2 h、6 h、12 h、24 h、48 h患者的疼痛强度进行评估。 结果氯胺酮组与生理盐水对照组术后24、48 h切口周围的疼痛阈值分别为(4.3±0.4) g比(3.9±0.4) g、(4.2±0.4) g比(3.8±0.4) g(P<0.05),而在非手术区域的前臂疼痛阈值,两组在各时间点差异均无统计学意义(P>0.05)。 结论氯胺酮能够降低甲状腺手术中瑞芬太尼引起的痛觉过敏。Objective To evaluate the effects of ketamine on remifentanil-induced postoperative hyperalgesia in patients undergoing thyroid surgery. Methods Forty patients scheduled to undergo thyroid surgery were randomly divided into two groups (n=20): a ketamine group and a control group. The pain thresholds were measured by von Frey filaments 24 h and 48 h after surgery. The pain intensity was evaluated 30 min, 2 h, 6 h, 12 h, 24 h and 48 h after surgery. Results The pain threshold in the ketamine and control groups was (4.3±0.4) g vs (3.9±0.4) g and (4.2±0.4) g vs (3.8±0.4) g at 24 h and 48 h after surgery (P<0.05), respectively. Postoperative pain intensity was similar between the two groups (P>0.05). Conclusions A low-dose infusion of ketamine can reduce remifentanil-induced postoperative hyperalgesia in patients undergoing thyroid surgery.

关 键 词：氯胺酮 瑞芬太尼 痛觉过敏 

分 类 号：R614[医药卫生—麻醉学]