氯胺酮超前镇痛在剖宫产手术中的应用

Effects of preemptive analgesia of ketamine using in patients undergoing uterine-incision delivery operation

目的：探讨氯胺酮在剖宫产手术中的超前镇痛作用。方法：择期在硬膜外麻醉下行剖宫产手术患者40例,年龄20-40岁,ASAⅠ或Ⅱ级,随机分为两组,每组20例。Ⅰ组在术前10min静注氯胺酮1mg/kg,继之以1mg/（kg·h）持续泵入至手术结束,Ⅱ组为对照组,单纯应用硬膜外麻醉。观察术后感觉疼痛时间,镇痛药用量及术后各时点VAS评分。结果：两组病人在手术时间上无统计学差异。术后疼痛开始时间,Ⅰ组比Ⅱ组明显延长（P〈0.05）,PCA术后用药量Ⅱ组〉Ⅰ组,两组VAS评分Ⅱ组明显高于Ⅰ组。结论：剖宫产手术在术前及术中应用氯胺酮能明显降低术后病人PCA用药量,具有明显超前镇痛作用。

Objective：To observe preemptive analgesia of ketamine using in patients undergoing uterine-incision delivery operation. Methods：Forty ASA Ⅰ or Ⅱ patients aged 20-40 years undergoing uterine-incision delivery operation were randomly assigned to two groups：Group Ⅰ was given ketamine 1 mg/kg before skin incision,and 1 mg/（kg·h） ketamine was given through the operation. Group H was given only epidural anesthesia. Postoperative time of aching, the postoperative required analgesic dosage and VAS score of patients controlled analgesia were observed. Results： The postoperative time of aching was significantly longer in group Ⅰ than in group Ⅱ. The postoperative required analgesic dosage was obviously smaller in group Ⅰ than in group Ⅱ. The VAS scores was significantly lower in group Ⅰ than in group Ⅱ .Conclusion： Ketamine given before skin incision can lower the required analgesic dosage after operation ,preemptive analgesia was produced effectively.