摘要
目的研究小剂量氯胺酮(静脉麻醉药)预给药对全麻前或后导尿病人的膀胱刺激症的影响。方法骨科择期全麻下行腰椎减压内固定术病人80例,随机分为4组:麻醉前导尿预给氯胺酮组、麻醉前导尿对照组、麻醉后导尿预给氯胺酮组及麻醉后导尿对照组。观察病人膀胱刺激症(CRBD)的发生情况,并记录导尿前后无创血压(NIBP)、心率,以及恶心呕吐、嗜睡、幻觉、噩梦等不良事件。结果麻醉前导尿预给氯胺酮组,术后清醒期CRBD发生率及严重程度明显低于其他3组(P<0.05);麻醉前导尿对照组导尿前后NIBP和心率波动明显(P<0.05);各组病人清醒期不良事件发生无差异(P>0.05)。结论麻醉前导尿结合小剂量氯胺酮预给药是缓解导尿后CRBD的有效方法,对循环干扰较小,不增加不良事件发生率。
Objective To study the effect of ketamine premedication on patients with urinary catheter before or after general anesthesia . Methods A total of 80 ASA Ⅰ or Ⅱ patients for lumbar laminectomy were randomly assigned into 4 groups with 20 patients in each group ： group A, premedication ketamine and urinary catheter before anesthesia; group B, control group with normal saline and urinary catheter before anesthesia; group C , ketamine and urinary catheter after anesthesia; group D, control group with normal saline and urinary catheter after anesthesia. Severity of catheter related bladder discomfort （CRBD） ,level of sedation, post- operative nausea and vomiting （PONV） , hallucinations, night terror and diplopia were evaluated. Systolic blood pressure （SBP）, diastolic blood pressure（DBP） ,heart rate（HR） before and after catheter were recorded. Results The severity of CRBD is significantly decreased in the patients treated with premedication ketamine and urinary catheter before anesthesia （ P 〈 0.05 ）. There was statistically significantly differences were observed in values of SBP , DBP , HR before and after catheter in group B （ P 〈 0.05 ） . There were no statistically significantly differences were observed in level of sedation,PONV, hallucinations, night terror and diplopia in four groups （ P 〉 0.05 ）. Conclusion Ketamine premedication on patients with urinary catheter before general anesthesia is an effective way to relief the severity of CRBD. There wre lower interferences on circulation . There was no increase in incidence of side - effect .
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2008年第2期111-114,共4页
The Chinese Journal of Clinical Pharmacology
关键词
氯胺酮
膀胱刺激症
导尿
全身麻醉
ketamine
catheter related bladder discomfort
urinary catheterization
general anaesthesia
