氯胺酮复合右美托咪定对烧伤术后镇痛的探讨

Effect of analgesia of ketamine combined with dexmedetomidine on postoperative burn

目的探讨氯胺酮复合右美托咪定对大面积烧伤术后患者的镇痛效果。方法收集天津医科大学第二医院诊治的42例烧伤面积在30%~60%之间的患者为研究对象,按照办理住院时间分为观察组和对照组各21例,对照组应用氯胺酮静脉镇痛,观察组在对照组基础上复合使用右美托咪定,记录患者在不同时间点的生命体征,对术后镇痛进行评分,记录出现副反应例数。结果给药后2 h、12 h、24 h,对照组的心率和收缩压均高于观察组,对照组呼吸频率、SpO_2与观察组差异无统计学意义(P>0.05),观察组氯胺酮使用量、VAS评分、副反应发生率均低于对照组,差异有统计学意义(P<0.05)。结论小剂量氯胺酮复合右美托咪定对大面积烧伤患者行术后给药,镇痛效果明显,有助于改善患者生命体征,降低单药使用量,且副反应少,值得临床推广。

Objective To investigate the effect of analgesia of ketamine combined with dexmedetomidine on postoperative burn. Methods 42 cases of patients with burn area between 30% ~60% collected in The Second Hospital of Tianjin Medical University were selected and divided into control group and observation group according to the time of hospitalization, with 21 cases in each groups. The control group was treated with ketamine intravenous analgesia, and the observation group was treated with dexmedetomidine on the basis of the control group. The vital signs of the patients were recorded at different time points, the postoperative analgesia scores and the number of side effects were recorded. Results After administration of2 h, 12 h, 24 h, the heart rate and systolic blood pressure in the control group were higher than those in the observation group, the respiratory frequency, Sp O2 of the control group had no significant difference with those of the observation group（P0.05）, the dosage of ketamine, VAS score, the incidence of side effects of the observation group were lower than those of the control group, the differences were statistically significant（P 0.05）. Conclusion A small dose of ketamine combined with dexmedetomidine given to the large area burn patients after the operation, can improve the vital signs, reduce the use of single dose, and have obvious analgesic effect with less side effects, which is worthy of clinical promotion.