氯胺酮复合芬太尼联合新斯的明术后镇痛效果观察
氯胺酮,,],氯胺酮；芬太尼；新斯的明；术后镇痛,1资料与方法,2结果,3讨论,[参考文献]
[摘要] 目的 观察小剂量氯胺酮复合芬太尼联合新斯的明术后镇痛效果观察。方法 选择下肢手术的成年患者40例，随机分为两组，每组20例。Ⅰ组：氯胺酮复合芬太尼静脉给药术后镇痛。Ⅱ组：氯胺酮复合芬太尼静脉给药联合新斯的明硬膜外给药术后镇痛。观察各组患者镇痛48 h内静息镇痛评分(VAS)，恶心呕吐、皮肤瘙痒、尿潴留和幻觉发生情况。 结果 两组间48 h静息镇痛评分Ⅱ组均小于Ⅰ组，但无显著性差别(P>0.05)，两组间恶心呕吐发生率无显著性差异(P>0.05)，均无幻觉、尿潴留、皮肤瘙痒发生。 结论小剂量氯胺酮复合芬太尼静脉给药与联合新斯的明硬膜外给药均提供了满意的术后镇痛效果。[关键词] 氯胺酮；芬太尼；新斯的明；术后镇痛
Intravenous injection of small dosage of ketamine and fentanyl or combined with subdural injection of neostigmine for postoperative analgesia
DU Guoliang, LIU Dongmin, LIU Cuijie, LIN Zhengbin
(Mudanjiang Forest Central Hospital, Mudanjiang 157011, China)
Abstract： Objective To observe clinical effect of small dosage of Ketamine and Fentanyl or combined with Neostigmine for postoperation analgesia. Methods Totally 40 adult patients who had undergone lower limb operations were randomly divided into two groups according to medication for analgesia. In KF group, Ketamine and Fentanyl were used for analgesia. In KFN group, Ketamine and Fentanyl combined with Neostigmine were employed. Two groups were given full dosage of 2 μg·kg-1 Fentanyl through intravenous injection, then analgesia pump (2 ml/h) was used for postopretive analgesia. Medicine in pump were Fentanyl (0.2 μg·kg-1·h-1), Ketamine (120 μg·kg-1·h-1) and Droperidol (2.5 mg), diluted into 100 ml by Natrii chloride. At the same time, the KFN group was injected into subdural space with 1 mg Neostigmine, 0.3 mg Hydrobromide and 0.15 mg Bupivacaine, total volume amounted to 10 ml. The analgesic effect and score within 48 h were recorded according to VAS. Results The score within 48 h of KFN group was smaller than that of KF group, but without significant difference (P>0.05). There was no significant difference in occurrence of nausea and vomiting (P>0.05), and no illusion, urine retention and skin itch occurred in two grorups. ConclusionSmall dosage of Ketamine and Fentanyl or combined with subdural injection of Neostigmine can bothe provide satisfactory postoperative analgesic effect. ......
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