酮咯酸氨丁三醇对烧伤患者镇痛效应及麻醉深度的影响

目的探讨酮咯酸氨丁三醇对烧伤患者镇痛效应及麻醉深度的影响。方法将50例美国麻醉医师协会（ASA）I～Ⅱ级择期行烧伤植皮手术患者随机分为2组，每组25例。实验组静脉推注酮咯酸氨丁三醇30mg，对照组输注生理盐水，记录不同时点的脑电双频指数（BIS）、平均动脉压（MAP）及心率（HR）。术中以异丙酚和瑞芬太尼靶控输注（TCI）维持麻醉，调节异丙酚血浆靶控浓度（Ct），维持BIS稳定。结果麻醉剂诱导后，2组患者的HR及MAP均无显著性改变，但BIS均显著下降；给予药物后，实验组BIS继续下降。HR显著下降，MAP略有下降，而对照组上述指标均无明显变化。分别给予酮咯酸氨丁三醇和生理盐水后，实验组患者HR、MAP和BIS均显著低于对照组，差异有统计学意义；实验组异丙酚用量及苏醒期间咽喉疼痛、烦躁发生率均显著低于对照组，差异有统计学意义，而2组麻醉时间、呼吸恢复时间、睁眼时间及拔管时间比较，差异无统计学意义。结论酮咯酸氨丁三醇在不影响患者术后苏醒状态的情况下可产生明显镇痛效应，减少术中TCI异丙酚用量及不良反应的发生。

Effects of Ketorolac Tromethamine on the analgesic effect and anesthesia depth in burn patients

Objective To evaluate the effects of Ketorolac Tromethamine on the analgesic effect and anesthesia depth in burn patients. Methods A total of 50 I II burn patients judged by American Standards Association （ASA） underwent option forward skin grMting surgery were e qually divided into two groups. The patients in experimental group were intravenously injected 30 mg Ketorolac Tromethamine, while those in control group were injected normal saline. Bispectral index （BIS）, mean arterial pressure （MAP） and heart rate （HR） were recorded at different time points. During surgery, propofol and remifentanil were used by target controlled infusion （TCI） to control anesthesia, the plasma targeted controlled concentration （Ct） was regulate and BIS sta bilization was maintained during the operation. Results After induction by anesthetics, there was no HR and MAP variation in patients of two groups, but BIS went down significantly. After drugs administration, BIS, HR and MAP in experimental group decreased, among which HR evidently declined and MAP slightly decreased. However, there were no change in control group. After re spective administration of Ketorolac Tromethamine and normal saline, HR, MAP, B1S, amount of propofol and incidence of sore throat and irritability during wakening time in experimental group were markedly lower than that in control group. Therefore, the differences was statistically signifi cant. However, there was no statistical significance between two groups in the aspects of analgesic time, recovery time of respiratory and reviving time as well as tube removing time. Conehtsion Without affecting postoperative reviving status, Ketorolac Tromethamine can conspicuously generate analgesic effect. Meanwhile, it could reduce the amount of propofol by TCI during operation and decrease the occurrence of adverse reactions.