乳癌手术前静注氯胺酮对术后疼痛的影响

The Effect of Intravenous Injection of Ketamine Before Breast Tumor Operation on Past-operative Pain

目的 观察乳癌手术前静注氯胺酮对术后疼痛的影响。方法 6 0例ASAI -II级乳癌病人随机分为两组 ,每组各 30例。氯胺酮组用咪唑安定 0 .0 4mg·kg-1、芬太尼 2 .0 μg·kg-1、氯胺酮 1.0mg·kg-1、异丙酚 1.5mg·kg-1、卡肌宁 5 0mg麻醉诱导 ,对照组不用氯胺酮 ,术毕清醒后拔管。术后 2 4h内当VAS大于等于 6分时 ,肌注度冷丁 1mg·kg-1。比较两组术后 2 4h内肌注度冷丁人数 ,术后不良反应及病人满意率。结果 氯胺酮组术后16h内使用度冷丁人数明显减少 (P <0 .0 5 )。两组不良反应差异无显著性。氯胺酮组病人满意率更高。结论 乳癌手术前麻醉诱导加用氯胺酮能显著降低术后疼痛。

Objective To observe the effect of intravenous injection of ketamine before breast tumor operation on the relief of post-operative pain.Methods Sixty women patients,ASAI-II grade undergoing breast tumor operation were randomly divided into two groups receiving intravenous ketamine 1mg·kg -1 (ketamine group,n=30) or no ketamine (control group,n=30).The post-operative pain was measured by visual analogoue scale(VAS).When the VAS was over 6,the patients were injected intramuscular dolantin 1mg·kg -1 .The number of patients receiving intramuscular dolantin in the two groups during 24h after operation were recorded.Results The number of patients receiving intramuscular dolantin in control group was larger than that in ketamine group(P<0.05).There was more satisfaction in ketamine group compared to control group while there were no significant differences in side-effects between the two groups.Conclusion Addition of ketamine during anesthesia induction for patients undergoing breast tumor operation can reduce post-operative pain.