摘要
目的观察术后硬膜外持续泵入布托啡诺复合小剂量氯胺酮用于妇科患者术后的镇痛效果。方法60例ASAⅠ或Ⅱ级在腰-硬联合麻醉下行腹式子宫切除的妇科患者术后随机均分为两组,A组为观察组,用布托啡诺0.1 mg/kg+氯胺酮1 mg/kg+生理盐水至100 ml持续泵入;B组为对照组,用布托啡诺0.1 mg/kg+生理盐水至100 ml持续泵入。观察患者术后各时间段的视觉模拟镇痛评分(VAS)、Ramsay镇静评分及对术后镇痛的满意度进行评估,并观察不良反应情况。结果A组在给药后4 h的VAS低于B组(P<0.05);B组在给药后4、8和12 h的Ramsay镇静评分高于A组(P<0.05),但是两组的评分均在镇静满意的范围。结论硬膜外持续泵入布托啡诺0.1mg/kg对于妇科术后患者能提供安全有效的镇痛,同时复合小剂量的氯胺酮能增强其镇痛效果,不增加其不良反应的发生。
Objective To observe the analgesia and side effects of butorphanol combined with small dose of ketamine for postoperative continuous epidural analgesia. Methods Forty patients, underwent abdominal hysterectomy under combined spinal-epidural anesthesia （CSEA）, were randomized to two groups with 20 cases each, Group A received butorphanol 0.1 mg/kg in combination with ketamine 1 mg/kg in 100 ml normal saline,and group B butorphanol 0.1 mg/kg in 100 ml normal saline. Both groups received butophanol 1 mg epidurally as the loading dose, and followed by infusion in a rate of 2 ml/h. HR, MAP and respiratory rate were monitored in all patients. VAS score, Ramsay score, satisfaction score and requirement of rescue analgesia were recorded at preset time intervals. The postoperative complications were recorded as well. Results VAS scores of group A were significantly lower than those of group B at 4 h after administration （P〈 0.05）. Ramesay scores of group B were significantly higher than those of group A at 4,8,12 h after administration （P〈 0.05）. Ramsay scores of two groups were in the clinical satisfactory limit. Conclusion Butorphanol 0. 1 mg/kg in continuous epidural infusion of butorphanol safe and effective for postoperative analgesia. Butorphanol 0.1 mg/kg combined with small dose ketamine 1 mg/kg can improve the analgesic effect of butorphanol alone, without increasing the side effects.
出处
《临床麻醉学杂志》
CAS
CSCD
2008年第7期577-579,共3页
Journal of Clinical Anesthesiology
关键词
布托啡诺
术后镇痛
氯胺酮
Butorphanol
Postoperative analgesia
Ketamine
