氯胺酮预注对罗库溴铵注射痛及诱导期血压的影响

Effects of ketamine pretreatment on rocuronium-induced injection pain and blood pressure during anesthetic induction

目的探讨预注氯胺酮对罗库溴铵注射痛及诱导期血压的影响。方法全麻下行妇科腹腔镜手术患者120例随机分为四组:麻醉诱导前,S组静脉注射生理盐水5ml作为对照;K1、K2和K3组分别静脉注射氯胺酮0.25、0.5和1mg/kg。30s后评估患者的警觉/镇静评分(OAA/S),观察静脉注射罗库溴铵0.6mg/kg后的注射痛和血压变化。苏醒期间均未见氯胺酮相关的不良反应。结果 K1、K2和K3组的罗库溴铵注射痛发生率低于S组(60.0%、33.3%和3.3%vs.90.0%)(P<0.05),K3组又低于K1和K2组(P<0.05)。K3组诱导期10min内SBP和MAP的最大下降幅度低于S和K1组(P<0.05)。结论预注氯胺酮1mg/kg可以有效减轻罗库溴铵注射痛,且有利于维持全麻诱导期血压稳定。

Objective To investigate the effects of ketamine pretreatment on rocuroniuminduced injection pain and blood pressure during anesthesia induction.Methods A total of 120 patients scheduled for elective gynecological laparoscopy under general anesthesia was randomized into4 groups.Before anesthesia induction,the patients were injected with normal saline 5ml（group S）,ketamine 0.25mg/kg（group K1）,ketamine 0.5mg/kg（group K2）,or ketamine 1mg/kg（group K3）,which were followed by intravenous injection of rocuronium 0.6mg/kg.The local injection pain and OAA/S sedation score were evaluated.The changes of blood pressure during anesthesia induction and adverse effects after operation were recorded.Results The incidence rate was significantly lower in groups of K1,K2 and K3than that of group S（60.0%,33.3% and 3.3% vs.90.0%）（P〈0.05）,which was lower in group K3 than that in groups of K1 and K2（P〈0.05）.The decreases of SBP and MAP during anesthesia induction were significantly less in group K3 than those in groups of S and K1（P〈0.05）.There were no ketamine-associated adverse effects in groups of K1,K2 and K3.Conclusion Pretreatment with ketamine can efffectively attenuate rocuronium-induced injection pain and stabilize the blood pressure during anesthesia.