小剂量氯胺酮硬膜外腔自控镇痛用于剖宫产术后镇痛

Effect of Low-dose Ketamine in Patient-controlled Epidural Analgesia for Postoperation Analgesia after Cesarean Section

目的：评价小剂量氯胺酮硬膜外腔自控镇痛（PCEA）用于剖宫产术后的镇痛效果。方法：腰硬联合麻醉下行剖宫产病人80例，随机分为两组，每组40例（术后保留硬膜外管行PCEA）。观察组，首量：氯胺酮20mg＋0．5％布比卡因3ml＋0．9％生理盐水3ml；PCEA镇痛液配方：氯胺酮80mg＋0．5％布比卡因25ml＋氟哌啶2mg＋生理盐水至100ml。对照组，首量：吗啡1．0mg＋0．5％布比卡因3ml＋0．9％生理盐水3ml：PCEA镇痛液配方：吗啡5mg＋0．5％布比卡因25ml＋氟哌啶2mg＋生理盐水至100ml。结果：两组镇痛效果无显著差异（P〉0．05），但观察组副作用发生率低。结论：本法用于剖宫产术后镇痛效果较理想。

Objective To evaluate the effect of low-dose ketamine in patient-controlled epidural analgesia （PCEA） for postoperation analgesia after cesarean section, Methods 80 cesarean section patients with spinal-epidural anesthesia in ASA classes Ⅰ～Ⅱ under were randomly divided into the observation group and control group （n=40 each group）. The patients in the observation group received ketamine20mg, 0.5%bupivacaine 3ml and 0. 9% normal saline 3ml in a first; PCEA setting： ketamine80mg, 0.5%bupivacaine 25ml, droper^dol 2mg and 0.9% normal saline 100ml. Then the patients in the control group received morphine lmg, 0.5%bupivacaine 3ml and 0.9% normal saline 3ml in a first; PCEA setting： morphine 5mg, 0.5%bupivacaine 25ml, droperidol 2mg and 0.9% normal saline 100ml. The analgesic effect and side effects were compared in two groups. Results The analgesic effect of two groups had no difference （P〉0.05）; but the incidence of side effects n the observation group was lower than that in the control group. Conclusion The analgesic effect of low-dose ketamine in patient-controlled epidural analgesia is effective and good method for postoperation analgesia after cesarean section.