药物与临床
LIAO Zhipin;ZHANG yi;ZHANG Xianwei;TIAN Yuke
2006, 25(2): 0-0.
ObjectiveTo survey the clinical therapeutic effectiveness of subanesthetic doses of ketamine in postoperative patientcontrolled intravenous analgesia (PCIA) .Methods80 patients of ASA grade Ⅰ-Ⅱ were subjected to midlower abdominal operations under combined endo tracheal intubation and intravenous anesthesia. Microanalgesic pump was started to work at the time when the skin was sutured before termination of the surgery. The patients were then randomly divided into 4 equal groups: K1 (ketamine group 1), K2 (ketamine group 2), F (fentanyl group) and M (morphine group). The loading doses of the patientcontrolled analgesics of the 4 groups were 0.25 mg·kg-1,0.50 mg·kg-1,1g·kg-1 and 0.15 mg·kg-1,respectively .The background infusion doses were 10 mg·h-1, 20 mg·h-1 ,10 g·h-1 and 1 mg·h-1, respectively ,while the pressing doses were 10 mg, 20 mg, 10 g and 0.5 mg , respectively ,with intervals of 5 min. Heart rate, blood pressure ,respiratory rate , pulse blood oxygen saturation ,visual analogue score(VAS),Prince Henry Score (PHS),sedation score(SS) and incidence of adverse reactions within the following 24 h were kept under observation and total doses of the drugs used in the 24 h were noted down.ResultsThe VAS and PHS in patients of group K1 were strikingly higher than those of the other 3 groups (P<0.05). The differences between the SS in patients of the 4 groups were not significant (P>0.05). The postoperative incidence of nausea and vomiting in patients of group M was higher than those in patients of the other 3 groups (P<0.05). The incidences of delayed postoperative flatus passing in patients of group F and group M were higher than those in patient of group K1 and group K2 (P<0.05).ConclusionWhen used in postoperative PCIA, proper subanesthetic doses of ketamine was shown to exert the same and satisfying effects as those of morphine or fentanyl and the incidences of nausea, vomiting and delayed flatus passing in patients treated with ketamine were lower than those in patients treated with morphine.