氯胺酮复合曲马多用于术后静脉镇痛

目的研究氯胺酮复合曲马多术后静脉镇痛的临床效果。方法60例ASAⅠ-Ⅱ级全麻上腹部手术患者随机分为两组：A组（30例）曲马多800mg加格拉斯琼3mg,B组（30例）曲马多400mg加氯胺酮100mg加格拉斯琼3mg。两组均以生理盐水稀释到100ml,按2．0ml／h速度使用一次性微量连续输液器静脉持续镇痛48h。比较两组镇痛效果,以及恶心、呕吐、皮肤瘙痒、尿潴留、嗜睡、呼吸抑制等并发症的发生率。结果两组患者术后48h镇痛效果均满意。视觉模拟评分（VAS）差异无统计学意义,但B组术后恶心、呕吐、皮肤瘙痒、尿潴留、嗜睡发生率显著低于A组（P〈0．01）。结论氯胺酮复合曲马多术后静脉镇痛是安全有效的,可减少曲马多用量及其不良反应的发生率。

Ketamine combined with tramadol for postoperative intravenous analgesia

Objective To evaluate the clinical efficacy of ketamine combined with tramadol for postoperative intravenous analgesia. Methods Sixty ASA Ⅰ -Ⅱ patients underwent spinal surgery were dcvided into two groups with 30 cases each. Ketamine 100 mg plus tramadol 400 mg was used in group B, and tramadol 800 mg alone in group A as a control. Granisetron 3 mg was added into the analgesic solution that was diluted to 100 ml with normal saline in both groups. Analgesic solution was infused continuously in a dose of 2 ml/h for 48 h postoperatively and analgesia was evaluated by VAS and side effects were recorded. Results Postoperative analgesia was satisfactory in both groups, but the side effects including nausea,vomiting,skin pruritus and lethargy were significantly less in group B than those in group A（ P 〈 0.01 ）. Conclusions Ketamine combined with tramadol is effective and safe for postoperative intravenous analgesia with the advantages of reducing tramadol requirement and its side effects.