小剂量氯胺酮联合舒芬太尼对食管癌根治术后镇痛效果的影响

发布时间：2018-06-16 00:14

本文选题：氯胺酮 + 舒芬太尼　；参考：《中国药房》2015年30期

【摘要】：目的:探讨小剂量氯胺酮联合舒芬太尼对食管癌根治术后镇痛效果的影响。方法:153例实施食管癌根治术的患者均分为A、B、C组。各组患者麻醉诱导后,手术结束前30 min应用镇痛药物。A组患者给予舒芬太尼2μg/kg;B组患者给予舒芬太尼2.5μg/kg;C组患者给予舒芬太尼2μg/kg+氯胺酮85μg/(kg·h)。观察各组患者麻醉前及麻醉后4、8、16、24、48 h时视觉模拟评分法(VAS)评分及Ramsay评分,镇痛泵按压次数及不良反应发生情况。结果:各组患者麻醉后4、8、16 h时Ramsay评分均显著高于同组麻醉前,差异均有统计学意义(P0.05),但各组间比较及各组患者麻醉后24、48 h时Ramsay评分与同组麻醉前比较,差异均无统计学意义(P0.05);各组患者麻醉后各时间点(C组48 h除外)VAS评分均显著高于同组麻醉前,但C组B组A组,差异均有统计学意义(P0.05)。C组患者镇痛泵平均按压次数B组A组,A、C组患者不良反应发生率B组,差异均有统计学意义(P0.05)。结论:小剂量氯胺酮联合舒芬太尼用于食管癌根治术患者在不降低镇痛效果的情况下,可减少舒芬太尼的用量,且安全性较好。
[Abstract]:Objective: to investigate the effect of low-dose ketamine combined with sufentanil on postoperative analgesia of esophageal carcinoma. Methods 153 patients underwent radical resection of esophageal carcinoma were divided into two groups. After anesthesia induction, sufentanil was given to patients in group A 30 min before operation. Sufentanil was given to patients in group B with sufentanil 2.5 渭 g / kg and group C was given sufentanil 2 渭 g/kg ketamine 85 渭 g/(kg. The visual analogue scores (VASs) and Ramsay scores, the number of analgesic pump compressions and the occurrence of adverse reactions were observed before anesthesia and 48 hours after anesthesia. Results: the Ramsay scores in each group were significantly higher than those in the same group at 816 hours after anesthesia, and the differences were statistically significant (P 0.05). However, the Ramsay score of each group at 2448 hours after anesthesia was significantly higher than that of the same group before anesthesia. The VAS score of group C was significantly higher than that of group C at 48 h after anesthesia, but that of group B was significantly higher than that of group A. There was significant difference in the incidence of adverse reactions between group A and group A (P 0.05), and the difference was statistically significant (P 0.05). Conclusion: low dose ketamine combined with sufentanil can reduce the dosage of sufentanil without reducing the analgesic effect, and the safety is good.
【作者单位】：温州市中心医院麻醉科;温州医科大学附属第一医院麻醉科;
【分类号】：R614;R735.1

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