小剂量氯胺酮在颈髓损伤患者术后疼痛中的应用

Application of Low-dose Ketamine in Postoperative Analgesia for Patients after Cervical Spinal Cord Injury(review)

氯胺酮是一种强力、短效镇痛药,在休克、哮喘等时具有一定优点。但因其副作用明显,临床上受到限制。近年来,小剂量氯胺酮(≤1mg/kg)与阿片类药物混合使用,可以增强阿片类药物的镇痛效果,减少其用量,并具有较好的稳定性,且不增加呼吸抑制作用,有利于术后机体功能恢复,不会引起幻觉和认知功能障碍等特点,因此适用于易发生呼吸抑制的颈髓损伤患者。同时,还有类似抗抑郁药的作用,对有抑郁症状的患者更佳。

Ketamine is mighty and short effective antalgic, advantaged in shock, asthma, etc. but it is restricted clinically because of serious side-effect. Today, low-dose ketamine（≤1 mg/kg） combined with opiates can enhance the efficacy of the opiates so that the dose of the opiates decrease relatively. The ketamine-opiates solution has enough stability and respiratory problems don＇t appear. So it is feasible that the combination of the two medicines can be used for patients with cervical spinal cord injury, who are susceptive to the respiratory distress and especially for the patients with depression.