摘要
目的研究吗啡联合氯胺酮单次注入硬膜外术后镇痛效果和不良反应。方法选择下肢骨折手术患者66例,随机分成两组,全部选择硬膜外麻醉。局麻药使用利多卡因、丁卡因混合液。吗啡组(M组)药物配方为吗啡2 mg,氯胺酮联合吗啡组(KM组)药物配方为吗啡2 mg+氯胺酮10 mg。均以生理盐水稀释到5 ml。手术结束前半小时将各组药物注入硬膜外腔,观察注药前、后10 min SBP、DBP、HR、SpO2的变化,48h内镇痛效果及不良反应。结果两组药物对循环呼吸功能均无明显改变。KM组的疼痛评分在各时间点均明显低于M组在相同时间点的疼痛评分(P<0.01),而不良反应M组和KM组之间差异无统计学意义(P>0.05)。结论硬膜外吗啡联用氯胺酮术后镇痛有镇痛效果确切、持续时间长、术后镇静满意、患者感觉良好的优点,是一种更为切实可行的方法。
Objective To study the analgesic efficacy and disadvantageous influence of postoperative analgesia with epidural injection of morphine and ketamine. Methods Sixty-six patients undergoing surgical operation in lower limbs were randomly divided into two groups （ n = 33/group）. Epidural anesthesia was performed with mix drug of lidocanine hydrochloride and dieaine hydroehloride. Postoperative analgesia was performed with 2 mg of morphine （Group M） or 2 mg of morphine and 10 mg of ketamine （Group KM）. Half hour before the operation was ended, the drug solution was injected by cpidural catheter. Some parameters, such as rterial systolic blood press （SBP） , arterial diastolic blood press （DBP） , heart rate （HR） and saturation of pulse oxygen （ SpO2 ） , were measured at 10 min before and after drug injection. The analgesic efficacy and disadvantageous influence of postoperative analgesia in 48 hours were observed. Results The changes in circulation and respiration were not significant in the two groups. The pain score of Group KM at each time point was significantly lower than that of Group M （ P 〈 0.01 ）. There was no significant difference in side effects between Group M and Group KM （ P 〉 0.05 ）. Conclusion The postoperative analgesic efficacy of morphine and ketamine is more satisfactory than that of morphine.
出处
《临床军医杂志》
CAS
2008年第5期710-711,共2页
Clinical Journal of Medical Officers
关键词
硬膜外
术后镇痛
吗啡
氯胺酮
epidural
postoPerative analgesia
morphine
ketamine
