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氯胺酮超前镇痛对腹腔镜胆囊切除术后镇痛的影响
引用本文:戴载深,何永传.氯胺酮超前镇痛对腹腔镜胆囊切除术后镇痛的影响[J].现代医院,2006,6(7):38-40.
作者姓名:戴载深  何永传
作者单位:广州市番禺区何贤医院,广东,广州,511400
摘    要:目的评价术中应用低剂量氯胺酮对曲马多术后镇痛效果的影响。方法将40例腹腔镜胆囊切除病人随机分成两组,K组:术中给予氯胺酮(0·75mg/kg);T组:曲马多(1·5mg/kg)用作术后镇痛,病人术后如有需要,可追加曲马多,记录总剂量,评价不良反应。结果术中使用氯胺酮可在病人苏醒时产生良好的镇痛效果,约持续1h,可增强术后曲马多的止痛效果。K组的不良反应发生率(15/20)较T组(10/20)高(p>0·05),但高危并发症如呼吸抑制、低血压等的发生率K组(0/20)较T组(3/20)低(p<0·05)。结论术中预先给予低剂量的氯胺酮可在术后产生足够的镇痛作用及增强曲马多的镇痛效果;使用氯胺酮的并发症较曲马多为多,但是后者所引起的并发症却比前者要危险得多。

关 键 词:超前镇痛  氯胺酮  曲马多  全身麻醉  腹腔镜胆囊切除术

THE EFFECTS OF PREEMPTIVE KETAMINE ON POSTOPERATIVE ANALGESIA FOR PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY DURING GENERAL ANESTHESIA
DAI Zaishen,HE Yongchuan.THE EFFECTS OF PREEMPTIVE KETAMINE ON POSTOPERATIVE ANALGESIA FOR PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY DURING GENERAL ANESTHESIA[J].Modern Hospital,2006,6(7):38-40.
Authors:DAI Zaishen  HE Yongchuan
Abstract:Objective To evaluate preemptive perioperative analgesia with low-doses ketamine for patients undergoing laparoscopic cholecystectomy during general anesthesia. Methods 40 patients undergoing laparoscopic cholecystectomy were randomly assigned into 2 groups: postoperative analgesia was performed with the intraoperative administration of ketamine (0.75 mg/kg)(Group K, n=20) or tramadol (1.5 mg/kg) (Group T, n=20). Supplemental doses of tramadol were administered if required, also to quantify the adequacy of analgesia, and adverse effects were evaluated. Results Preemptive intraoperative analgesia with ketamine produces a good analgesia at the awakening, despite low duration (approximately 1 hour), and upgrades the analgesic effect of tramadol in the postoperative period. Although the rate of adverse effects Group K (15/20)is higher than that in Group T(10/20)(p>0.05), but the rate of dangerous adverse effects(such as respiratory depression and hypotention)in Group K(0/20) is lower than that in Group T(3/20)(p<0.05). Conclusion Preemptive low-doses ketamine is able to produce an adequate postoperative analgesia and increases the analgesic effect of tramadol; Although the adverse effects due to ketamine are more numerous than those related to tramadol, the later could potentially be more dangerous.
Keywords:Preemptive analgesia  Ketamin  Tmmadol  General anesthesia  Laparoscopic colecystectomy
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