CAJ | 학술논문

目的：探讨氟比洛芬酯或小剂量氯胺酮对雷米芬太尼麻醉术后痛觉过敏的预防作用．方法选择120例ASAⅠ或Ⅱ级麻醉患者，随机平均分为3组，A组（40例）给予静脉注射氯胺酮0.5 mg/kg，然后5μg/(kg. min)静脉维持，B组（40例）术前给予100 mg氟比洛芬酯静脉注射，C组（40例）不用氟比洛芬酯或氯胺酮作为对照．术后均用曲马多持续静脉自控镇痛（PCIA）．结果术后1、2、4、8 h，C组患者视觉模拟评分（VAS）明显高于A组和B组（＜0.05）；术后24 h，3组间VAS差异无统计学意义（＞0.05）．C组术后加用芬太尼镇痛例数为25例、术后24 h PCIA自控按压次数为（8.6±4.2）次均明显多于A组的7例和（3.3±2.8）次以及B组的6例和（3.2±2.2）次（＜0.05）．结论术前给予氟比洛芬酯或术中持续给予氯胺酮均能预防雷米芬太尼麻醉术后痛觉过敏的发生，同时不会影响患者苏醒，安全可靠，值得临床推广和普及．
목적：탐토불비락분지혹소제량록알동대뢰미분태니마취술후통각과민적예방작용．방법선택120례ASAⅠ혹Ⅱ급마취환자，수궤평균분위3조，A조（40례）급여정맥주사록알동0.5 mg/kg，연후5μg/(kg. min)정맥유지，B조（40례）술전급여100 mg불비락분지정맥주사，C조（40례）불용불비락분지혹록알동작위대조．술후균용곡마다지속정맥자공진통（PCIA）．결과술후1、2、4、8 h，C조환자시각모의평분（VAS）명현고우A조화B조（＜0.05）；술후24 h，3조간VAS차이무통계학의의（＞0.05）．C조술후가용분태니진통례수위25례、술후24 h PCIA자공안압차수위（8.6±4.2）차균명현다우A조적7례화（3.3±2.8）차이급B조적6례화（3.2±2.2）차（＜0.05）．결론술전급여불비락분지혹술중지속급여록알동균능예방뢰미분태니마취술후통각과민적발생，동시불회영향환자소성，안전가고，치득림상추엄화보급．
Objective The purpose of this study was to investigate the preventive effect of flurbiprofen axetil or small-dose ketamine for remifentanil-induced postoperative hyperalgesia. Methods 120 anesthetized patients with ASA ⅠorⅡwere randomly divided into three groups. Group A (40 cases) was given 0.5 mg/kg of ketamine by intravenous injection,and 5μg/(kg.min) vein to maintain,group B (40 cases) was given 100 mg of preoperative flurbiprofen axetil by intravenous injection and group C (40 cases) had no flurbiprofen axetil or ketamine which was served as controls. After the treatment, all groups were given continuous intravenous tramadol controlled analgesia (PCIA) . Results After 1 h, 2 h, 4 h and 8 h, the visual analog scale (VAS) of group C was significantly higher than that of group A and group B ( <0.05);after 24 h, there was no statistically significant difference among the three groups in VAS scores ( > 0.05) . The number of fentanyl analgesia were 25 cases and postoperative 24 h PCIA self-control were (8.6 ±4.2) times, which were more than 7 cases and (3.3 ±2.8) times of group A, and 6 cases and (3.2 ± 2.2) times of group B ( <0.05) . Conclusion The preoperative administration of flurbiprofen axetil or intraoperative continuously administered ketamine is able to prevent the occurrence of remifentanil-induced postoperative hyperalgesia, and it will not affect the patient regained consciousness. The method is safe and reliable,so it is worth promoting and popularizing.