小剂量氯胺酮缓解患儿术中泵注瑞芬太尼所致痛觉过敏临床研究

目的用小剂量氯胺酮干预小儿术中应用瑞芬太尼后痛觉过敏的发生,使小儿术后安静和完善镇痛.方法选择31例施行不同手术治疗的儿童,随机分成三组.组一、组二分别于缝皮前静注氯胺酮0.5mg/kg、0.25 mg/kg,组三为对照组,不给氯胺酮.观察三组患儿拔管后5 min、10 min、20 min、30 min的心率、安静率、哭闹率、定向力恢复率、疼痛VAS评分.结果组一、组二应用小剂量氯胺酮后,安静率比组三高,而哭闹率比组三低;定向恢复率、疼痛VAS评分三组间无差异.结论小剂量氯胺酮可以缓解患儿术后的痛觉过敏,且不影响苏醒.同时,以0.5 mg/kg氯胺酮静注为佳.

Small-dose Ketamine for Hyperalgesia after Remifentanil iv.Pump in Child Patients

Objective To intervene the hyperanglesia after use of Remifentanil in child patients with small-doses Ketamine,so as to got sedative and anti-analgestic effects.Methods Thirty-one child patients undergoing surgery under Remifentanil iv.pump were randomly assigned to three groups.Child patients in group 1 and group 2 respectively received a bolus of Ketamine 0.5 mg/kg and 0.25 mg/kg iv.before skin suture.Child patients in group 3 didn＇t receive treatment and was as control group.We observed respectively HR,calm and crying condition,orientation recovery rate and pain VAS of patients at 5 min,10 min,20 min and 30 min after extubation in the three groups.Results In Group 1 and Group 2,the rate of children patients in calm conditions was higher,and the rate of crying patients was lower than in Group 3.There was no difference in orientation recovery rate and pain VAS among the three groups.Conclusion Small-dose Ketamine can release hyperanaglesia after operation and doesn＇t effect palinesthesia.Meanwhile,the method of Ketamine 0.5 mg/kg iv.is the best.