小剂量氯胺酮复合舒芬太尼术后静脉镇痛的临床观察

目的：比较小剂量氯胺酮复合舒芬太尼与单纯舒芬太尼用于术后静脉镇痛的临床疗效。方法选择80例ASAⅠ~Ⅱ级下肢骨折行切开复位内固定术的患者，随机分成两组，每组40例，均以一次性静脉镇痛泵行术后镇痛。KS组：氯胺酮80μg/（kg·h）＋舒芬太尼0.25μg/（kg·h）；S组：舒芬太尼0.5μg/（kg·h）。两组镇痛泵中药物均用生理盐水稀释至100 ml。观察并记录患者术后6、12、24、48 h 镇痛评分、恶心呕吐、皮肤瘙痒、尿潴留和幻觉的发生率。结果 KS组各时点的镇痛评分均较S组低（P﹤0.05）。S组的恶心呕吐、皮肤瘙痒、尿潴留发生率较KS组高（P﹤0.05）。两组患者均无幻觉发生。结论小剂量氯胺酮在术后静脉镇痛中能增强舒芬太尼的镇痛作用，且不增加不良反应。

Clinical observation of small dose ketamine combined with sufentanyl for postoperative intravenous analgesia

Objective To compare the clinical effects of small dose ketamine combined with sufentanyl and single use of sufentanyl on postoperative intravenous analgesia. Methods Eighty patients with ASAⅠ~Ⅱstage lower limb fracture under-went open reduction and internal fixation were randomly divided into two groups,with 40 cases in each group. All of the patients were given disposable intravenous analgesia pump. Group KS：ketamine 80 μg/（ kg·h）plus sufentanyl 0. 25 μg/（ kg·h）;Group S：sufentanyl 0. 5 μg/（kg·h）. The drugs in each group were diluted in 100 ml normal saline. The analgesia scores,in-cidences of nausea and vomiting,skin itching,urinary retention and illusion were recorded at 6,12,24,48 hours after operation. Results The analgesia scores of group KS at each time point were significantly lower than those of group S（P﹤0. 05）. The in-cidences of nausea,vomiting,skin itching and urinary retention of group S were significantly higher than those of group KS（ P﹤0. 05）. There was no case of illusion occured in the two groups. Conclusion Small dose of ketamine used for postoperative in-travenous analgesia can enhance the efficacy of sufentanyl,without increasing the side effects.