CAJ | 학술논문

目的探讨氯胺酮静脉镇痛对严重烧伤患者急性期应激反应的影响.方法 40例严重烧伤患者于伤后24 h内入院,随机均分为患者自控静脉镇痛组(PCIA组)和对照组(C组).检测镇痛开始前及开始后1、8、24、48 h的血糖、血浆胰岛素(Ins)、促肾上腺皮质激素(ACTH)、皮质醇(Cor)、肾上腺素(AD)和去甲肾上腺素(NA)的水平.结果 PCIA组镇痛效果明显优于C组(P<0.01);PCIA组镇痛后1～48 h血糖和镇痛后8～48 h血浆应激激素与镇痛前及C组比较明显降低(P<0.05或P<0.01).两组患者均无恶心、呕吐、幻觉以及呼吸抑制等不良反应.结论小剂量氯胺酮PCIA可有效地降低严重烧伤患者急性期的应激反应.
목적 탐토록알동정맥진통대엄중소상환자급성기응격반응적영향.방법 40례엄중소상환자우상후24 h내입원,수궤균분위환자자공정맥진통조(PCIA조)화대조조(C조).검측진통개시전급개시후1、8、24、48 h적혈당、혈장이도소(Ins)、촉신상선피질격소(ACTH)、피질순(Cor)、신상선소(AD)화거갑신상선소(NA)적수평.결과 PCIA조진통효과명현우우C조(P<0.01);PCIA조진통후1～48 h혈당화진통후8～48 h혈장응격격소여진통전급C조비교명현강저(P<0.05혹P<0.01).량조환자균무악심、구토、환각이급호흡억제등불량반응.결론 소제량록알동PCIA가유효지강저엄중소상환자급성기적응격반응.
Objective To investigate the effects of patient-controlled intravenous analgesia (PCIA) on stress response in patients with severe burn in acute stage. Methods Forty patients with severe burn and hospitalized within 24 hours after injury were randomly divided into two groups with 20 cases each. The patients in group A were given PCIA with small dose of ketamine and those in group C did not use PCIA as the controls. The blood glucose, insulin, ACTH, cordial, epinephrine and norepinephrine were measured before analgesia, at 1,8, 24 and 48 h during analgesia. Results Pain scores were significantly lower in group A than those before analgesia and in group C(P<0. 01). The serum levels of stress hormones were significantly lower in group A than those in group C(P<0. 05 or P<0. 01). No significant difference in side effects was found between two groups. Conclusion PCIA with small doses of ketamine can effectively reduce stress response in patients with severe burn in acute stage.