【摘要】 目的  观察在腹腔镜胆囊切除术中，氯胺酮超前镇痛对瑞芬太尼麻醉后急性疼痛的影响。 方法  2009年10月-2010年1月，将择期行腹腔镜胆囊切除术患者90例，随机分为对照组（C组）、氯胺酮超前镇痛组（K组）、氯胺酮术毕镇痛组（K1组），每组30例。所有患者均采用瑞芬太尼复合丙泊酚静脉麻醉，K组在切皮前静脉给予氯胺酮0.5 mg/kg，K1组在关腹前静脉给予氯胺酮0.5 mg/kg，C组不给予任何药物。记录术毕患者麻醉恢复情况，各时间点疼痛程度。 结果  K组、K1组躁动发生率均明显低于C组（P lt;0.05）；术后2、4、8、24 h，K组VAS评分及镇痛药使用率明显低于C组和K1组（P lt;0.05）。 结论  氯胺酮超前镇痛能明显降低瑞芬太尼术后疼痛，并且不增加并发症发生率。
【Abstract】 Objective  To evaluate the preemptive analgesia of ketamine on remifentanil induced acute postoperative pain after laparoscopic cholecystectomy. Methods  Ninty patients scheduled for laparoscopic cholecystectomy between october 2009 to Jannary 2010 were randomly assigned to three groups (n=30). Group K was administrated with 0. 5 mg/kg ketamine intravenously before skin incision, and Group K1 were administrated with 0. 5 mg/kg ketamine intravenously before abdominal closure, while Group C received nothing. The recovery and the side effects were recorded, the VAS at two, four, eight and 24 hours after surgery, and the use of anodyne were recorded. Results  The incidence of restlessness in Groups K and K1 was remarkably lower than that of Group C (P lt;0. 05). The analgesic effects two, four, eight and 24 hours after surgery were obviously better in group K than those of Group C and Group K1 (P lt;0. 05). Conclusion  Ketamine can produce preemptive analgesia to relieve remifentanil-induced acute pain, and it would not increase incidence of side effects.

Citation： ZHU Bo,LIU Ling. Preemptive Analgesia of Ketamine on Remifentanil Induced Acute Postoperative Pain. West China Medical Journal, 2010, 25(8): 1523-1524. doi: Copy