两种超前镇痛方法在前列腺切除术当中的应用

The application of both kinds of preemptive analgesia in prostatectomy

目的 :在前列腺切除术中,比较静脉和硬膜下隙给予亚麻醉剂量氯胺酮的超前镇痛作用。方法:30例择期前列腺切除手术病人随机分为3组。手术切皮前15min给药 ,Kiv组 :氯胺酮0.5mg.kg-1 用生理盐水稀释至10ml,1min内静脉推注 ;Kepi组 :氯胺酮0.5mg.kg-1 用生理盐水稀释至10ml,1min内注入硬膜下隙导管 ;对照组 :生理盐水10ml,1min内静脉推注。结果:各组VAS评分比较 ,术后Kepi组VAS评分明显低于Ctr组。术后FDAT比较 ,Kiv组和Kepi组明显长于对照组。术后48h吗啡用量各实验组用量显著少于对照组。结论:术前应用亚麻醉剂量氯胺酮延长术后镇痛时间、减少术后吗啡用量 ,有超前镇痛作用。

Objective:To compare the effect of Ketamine using subanesthesia dose intravenously or epiduraly on preemptive anaigesia in prostatectomy Methods:Thirty patients undergoing prostatectomy were randomly assigned into three groups.15 minutes before incision,Kiv group received ketamine 0.5 mg.kg-1 diluted in normal saline(NS) to 10 ml i.v, Kepi group receivedketamine 0.5 mg.kg-1 diluted in NS to 10 ml epidurally, Ctr group received NS 10 ml i.v.Result: VAS in Kepi group and Kiv group was significantly lower than that in Ctr group when postoperative 48 h.FDAT in Kepi group and Kiv group were significantly prolonged than that in Ctr group.Conclusion: Preoperative using a single subanesthesia dose of ketamine intravenously or epidurally can reduce postoperative pain, prolong FDAT and decrease PCEA morphine consumption.So epidural ketamine have efficacy of preemptive analgesia.