CAJ | 학술논문

目的：比较小剂量氯胺酮复合舒芬太尼与单纯舒芬太尼用于术后静脉镇痛的临床疗效。方法选择80例ASAⅠ~Ⅱ级下肢骨折行切开复位内固定术的患者，随机分成两组，每组40例，均以一次性静脉镇痛泵行术后镇痛。KS组：氯胺酮80μg/（kg·h）+舒芬太尼0.25μg/（kg·h）；S组：舒芬太尼0.5μg/（kg·h）。两组镇痛泵中药物均用生理盐水稀释至100 ml。观察并记录患者术后6、12、24、48 h 镇痛评分、恶心呕吐、皮肤瘙痒、尿潴留和幻觉的发生率。结果 KS组各时点的镇痛评分均较S组低（P﹤0.05）。S组的恶心呕吐、皮肤瘙痒、尿潴留发生率较KS组高（P﹤0.05）。两组患者均无幻觉发生。结论小剂量氯胺酮在术后静脉镇痛中能增强舒芬太尼的镇痛作用，且不增加不良反应。
목적：비교소제량록알동복합서분태니여단순서분태니용우술후정맥진통적림상료효。방법선택80례ASAⅠ~Ⅱ급하지골절행절개복위내고정술적환자，수궤분성량조，매조40례，균이일차성정맥진통빙행술후진통。KS조：록알동80μg/（kg·h）+서분태니0.25μg/（kg·h）；S조：서분태니0.5μg/（kg·h）。량조진통빙중약물균용생리염수희석지100 ml。관찰병기록환자술후6、12、24、48 h 진통평분、악심구토、피부소양、뇨저류화환각적발생솔。결과 KS조각시점적진통평분균교S조저（P﹤0.05）。S조적악심구토、피부소양、뇨저류발생솔교KS조고（P﹤0.05）。량조환자균무환각발생。결론소제량록알동재술후정맥진통중능증강서분태니적진통작용，차불증가불량반응。
Objective To compare the clinical effects of small dose ketamine combined with sufentanyl and single use of sufentanyl on postoperative intravenous analgesia. Methods Eighty patients with ASAⅠ~Ⅱstage lower limb fracture under-went open reduction and internal fixation were randomly divided into two groups,with 40 cases in each group. All of the patients were given disposable intravenous analgesia pump. Group KS:ketamine 80 μg/( kg·h)plus sufentanyl 0. 25 μg/( kg·h);Group S:sufentanyl 0. 5 μg/(kg·h). The drugs in each group were diluted in 100 ml normal saline. The analgesia scores,in-cidences of nausea and vomiting,skin itching,urinary retention and illusion were recorded at 6,12,24,48 hours after operation. Results The analgesia scores of group KS at each time point were significantly lower than those of group S(P﹤0. 05). The in-cidences of nausea,vomiting,skin itching and urinary retention of group S were significantly higher than those of group KS( P﹤0. 05). There was no case of illusion occured in the two groups. Conclusion Small dose of ketamine used for postoperative in-travenous analgesia can enhance the efficacy of sufentanyl,without increasing the side effects.