| 陈琴,章玲宾.右美托咪定复合氯胺酮对瑞芬太尼术后痛觉过敏的影响[J].浙江中西医结合杂志,2014,24(9): |
| 右美托咪定复合氯胺酮对瑞芬太尼术后痛觉过敏的影响 |
| Effects of dexmedetomidine with ketamine to prevent postoperative hyperalgesia induced by remifentanilCHEN Qin, ZHANG Ling-bin, FAN Li-hua, Department of Anesthesiology, Zhejiang Lishui People"s Hospital, Sixth Affiliated Hospital of Wenzhou Medical College, Zhejiang 323000, China. |
| 投稿时间：2014-02-11 修订日期：2014-06-20 |
| DOI： |
| 中文关键词: 右美托咪定 氯胺酮 痛觉过敏 |
| 英文关键词:Dexmedetomidine Ketamine Hyperalgesia |
| 基金项目:浙江省医学会临床科研项目(项目编号2010ZYC-A48) |
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| 中文摘要: |
| 目的：观察右美托咪定复合氯胺酮对瑞芬太尼术后痛觉过敏的影响。方法：选取妇科择期全麻手术患者60例，ASA I～II级，随机分为三组(A组、B组、C组)，每组20例。手术结束前30mins，A组静脉注射氯胺酮0.5mg/kg、B组静脉泵注右美托咪定0.5μg/kg、C组静脉泵注右美托咪定0.5μg/kg，并静脉注射氯胺酮0.5mg/kg。分别记录各组苏醒时间、拔管时间 、拔管时患者血流动力学指标及术后恶心、呕吐等不良反应的发生情况。于拔管后30mins，60mins和120mins对患者进行VAS疼痛和Ramsay镇静评分。结果：三组患者苏醒时间、拔管时间、拔管时血流动力学指标及术后恶心、呕吐的发生率在统计学上无显著性差异(P>0.05)；清醒后各时间点VAS评分C组低于A、B组 (P<0.05），对比存在显著差异，具有统计学意义(P<0.05)。Ramsay镇静评级C组等级最高，A组及B组次之，差异性显著，存在统计学意义(P<0.05)。结论：右美托咪定及氯胺酮均可以减轻瑞芬太尼麻醉后的痛觉过敏，但右美托咪定复合氯胺酮效果优于单独使用氯胺酮或右美托咪定，无明显不良反应，同时可产生镇静作用。 |
| 英文摘要: |
| Objective: To Observe the effects of dexmedetomidine with ketamine to prevent postoperative hyperalgesia induced by remifentanil. Method: Sixty (ASA I ~ II)patients of aged(25-65 years) who undergoing elective gynecological surgery under general anesthesia were randomly divided into three groups (Group A， B， C)， N = 20 in each group. 30mins before the end of surgery， the patients in group A were injected with ketamine 0.5mg/kg、the patients in group B were given an intravenous infusion of dexmedetomidine 0.5μg/kg with mini‐pump、Group C were given an intravenous infusion of dexmedetomidine 0.5μg/kg with mini‐pump， and were injected with ketamine 0.5mg/kg. The awakening time、extubation time 、hemodynamics in patients with extubation and the incidence of postoperative nausea and vomiting were recorded．VAS scores and Ramsay sedation scores were also recorded at the time of 30mins、60mins and 120mins after extubation. Result: The awakening time、 extubation time 、 hemodynamics during extubation and the incidence of postoperative nausea and vomiting had no significant differences among the three groups (P> 0.05); The VAS scores of group C were lower than group A and B (P <0.05)， there had the statistically significant differences. The Ramsay sedation scores of the group C were the highest ， group A and B followed by， there also had significant differences (P <0.05). Conclusion: Dexmedetomidine and ketamine can be given to reduce hyperalgesia induced by remifentani， but the effects of dexmedetomidine combined with ketamine were better than that of ketamine or dexmedetomidine alone， at the same time it can produce sedation. |
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