摘要
目的探讨小剂量氯胺酮对小儿扁桃体切除术(tonsillectomy,TE)术后镇痛及炎性因子的影响。方法以择期全身麻醉下行扁桃体切除术患儿60例作为研究对象,年龄3~7岁,随机分为三组,每组20例,试验组(LKS组和HKS组)在麻醉前分别给予氯胺酮0.25 mg/kg和0.5 mg/kg,对照组(SF组)给于等量的生理盐水,术毕连接镇痛泵,泵配方为:SF组(舒芬太尼3 μg/kg+昂丹司琼0.15 mg/kg +0.9%生理盐水),LKS组和HKS组均为(舒芬太尼2 μg/kg +昂丹司琼0.15 mg/kg +0.9%生理盐水);总量配成150 ml,持续量2 ml/h+PCA 0.5 ml/次,使用时间72 h。记录术后拔管即刻镇静和疼痛评分,以及术后6 h、12 h、24 h、48 h、72 h的疼痛评分及术前、术后上述各时间点血浆C反应蛋白(CRP)浓度,并记录不良反应发生情况。结果与SF组比较,LKS组、HKS组在术后即刻及术后6 h、12 h、24 h、48 h的疼痛评分降低(P<0.05);术后PCA按压次数及两次按压时间间隔减少(P<0.05);术后CRP浓度在6 h、12 h、24 h降低(P<0.05)。不良反应与SF组比较,LKS组及HKS组恶心呕吐、呼吸抑制发生率降低(P<0.05)。结论小剂量氯胺酮可显著降低小儿扁桃体切除术术后舒芬太尼镇痛的疼痛评分及CRP水平,且不增加不良反应。
Objective To investigate the influence of low-dose ketamine on postoperative analgesia and inflammatory factors in children with tonsillectomy(TE). Methods The 60 cases of schemed tonsillectomy patients underwent tonsillectomy(aged 3-7 years),were randomly divided into three groups,20 cases in each group. The trial group(LKS group and HKS group) were given ketamine 0.25mg/kg and 0.5mg/kg before anesthesia,and control group(SF group) was given the same amount of normal saline,connected to the analgesic pump after surgery,pump formula:SF group(sufentanil 3μg/kg+ondansetron 0.15mg/kg+0.9% saline),The LKS group and the HKS group were(Sufentanil 2μg/kg+Ondansetron 0.15mg/kg+0.9% saline);the total amount was 150 ml,The total amount is 150ml,the sustained amount was 2ml/h+ patient-controlled analgesia(PCA) 0.5ml/time,for 72h. The immediate postoperative Ramsay sedation,and pain scores were recorded,as well as the pain scores at 6h,12h,24h,48h,and 72h postoperatively,and plasma C-reactive protein(CRP) concentrations before and at each of the above-mentioned time points were recorded and recorded,as well unward reaction. Results Compared with SF group,the pain scores of LKS group and HKS group at the immediate postoperative and 6h,12h,24h and 48h postoperatively decreased(P<0.05);the number of PCA compressions and the interval between two presses decreased after surgery(P<0.05);Postoperative CRP concentration decreased at 6h,12h,24h(P<0.05). Adverse reactions Compared with SF group,the incidence of nausea and vomiting and respiratory depression in LKS group and HKS group decreased(P<0.05). Conclusion Low-dose ketamine can significantly reduce pain scores and CRP levels after sufentanil analgesia in children after tonsillectomy,and does not increase adverse reactions.
作者
曾毅
高国一
李忠云
ZENG Yi;GAO Guo-yi;LI Zhong-yun(Dept. of Anesthesia,the People's Hospital of Xishuangbanna Dai Autonomous Prefecture,Jinghong,Yunnan 666100,China)
出处
《实用医药杂志》
2019年第8期696-699,共4页
Practical Journal of Medicine & Pharmacy
关键词
扁桃体切除术
氯胺酮
术后镇痛
儿童
Tonsillectomy
Ketamine
Postoperative analgesia
Children
