静脉低剂量氯胺酮超前镇痛对腹腔镜胆囊切除术后苏醒和疼痛的影响

摘要

目的 观察氯胺酮切皮前给药对腹腔镜胆囊切除术(LC)后苏醒和疼痛的影响.方法 全麻下行LC患者80例,随机均分为两组:对照组采用雷米芬太尼复合丙泊酚麻醉;研究组在切皮前加用小剂量氯胺酮0.3 mg/kg.采用SS和VRS评分评估对苏醒时间和苏醒期躁动情况.结果 两组呼吸恢复时间、睁眼时间、拔管时间差异无统计学意义.研究组苏醒期躁动、镇痛、镇静效果显著优于对照组(P<0.05).结论 静脉低剂量氯胺酮超前镇痛用于LC术后苏醒快,术后疼痛轻,苏醒期躁动少.%Objective To observe the effect of ketamine preemptive analgesia on postoperative pain and recovery in laparoscopic cholecystectomy(LC). Methods Eighty LC patients under general anesthesia with propofol and remifentany were randomly divided into two groups of PR and PRK with 40 cases each. The patients in group PRK were given additional low-dose ketamine 0.3 mg/kg before skin incision. Recovery from anesthesia was evaluated at 30 min, 1 h and 12 h after surgery by SS and VRS scoring. Results There were no significant differences in the time for regaining spontaneous breathing,opening eyes and extubation between the two groups. But recovery of anesthesia was with less restlessness and VRS pain scores, better sedation in group PRK than those in group PR (P< 0.05). Conclusion Preemptive intravenous analgesia with low-dose ketamine has the advantage of quicker recovery from anesthesia with less incidence of restlessness and pain in LC patients.