摘要
目的评估术后亚麻醉剂量的氯胺酮提高布托啡诺自控静脉镇痛(patient sey-controlled intravenous analgesia,PCIA)效果的可行性及应用价值。方法将2008年6月2009年5月收治的68例美国麻醉师协会(ASA)分级Ⅰ～Ⅱ级的择期外科手术患者随机分为B组(0.2mg/mL布托啡诺组)和BK组(0.2mg/mL布托啡诺和4mg/mL氯胺酮混合液组),每组34例。患者于手术结束后连接自控镇痛泵行自控PCIA。观察并记录拔除气管导管后及PCIA后1、4、8、12、24h患者疼痛评分视觉模拟评分(VAS)、镇静评分、血压、心率、血氧饱和度(SPO2)、按压次数和布托啡诺消耗量,以及呼吸抑制(SPO2≤92%)、恶心呕吐、尿潴留等并发症。结果 BK组24h布托啡诺用量减少40%,VAS评分降低,与B组比较差异均有统计学意义(P<0.05)。同时VAS>3的发生率明显减少(P<0.05)。镇静评分和过度镇静发生率降低,但差异无统计学意义(P>0.05)。恶心呕吐的发生率两组差异无统计学意义(P>0.05)。结论布托啡诺配伍亚麻醉剂量的氯胺酮在术后患者PCIA中能增强布托啡诺的镇痛效果,不良反应无明显增加。
Objective To evaluate the effects of minimal clinic dosage of ketamine improving the postoperative patient self-controlled intrauenous analgesia （PCIA） of butorphanol and reduce the side-effects simultaneously.Methods Between June 2008 to May 2009,68 selected surgery patients of ASA Ⅰ-Ⅱwere randomized into two groups with 34 each,group B （0.2 mg/mL butorphanol）and group BK （mixture of 0.2 mg/mL butorphanol and 4 mg/mL ketamine）. The vein of patients was connected with PCIA after surgery. The pain scores （VAS）,Ramsay score,blood pressure,heart rate,degree of blood oxygen saturation,press times,and the consumption of analgesics after extubation and PCIA at the 1st,4th,8th,12th and 24th hour were observed and recorded. Complications such as respiratory depression （SPO2≤92%）,nausea and vomiting,urinary retention were also recorded.Results Compared with group B,the consumption of butorphanol of group BK reduced by 40% with remarkable significance（P〈0.05）. VAS decreased,and had significant difference at the 1st,4th,12th hour（P〈0.05）,and the incidence of VAS decreased remarkably（P〈0.05）.Ramsay scores and the incidence of over sedation decreased but not significant（P〉0.05）; the incidence of nausea and vomiting had no significant difference in both groups（P〉0.05）. Conclusion Butorphanol combined with minimal dosage ketamine can enhance the sedation and reduce side effects of butorphanol in postoperative patients controlled analgesia,and there are no distinct adverse effects related to ketamine.
出处
《华西医学》
CAS
2010年第6期1108-1110,共3页
West China Medical Journal
关键词
布托啡诺
氯胺酮
自控静脉
镇痛
Butorphanol
Ketamine
Self-controlled intravenous
Analgesia
