河北医科大学学报

• 论著 • 上一篇    下一篇

不同剂量氯胺酮对罗库溴铵静脉注射痛反应及心血管反应的影响

  

  1. 海南省农垦总医院麻醉科,海南 海口 571100
  • 出版日期:2016-05-25 发布日期:2016-05-20
  • 作者简介:李繁( 1983- ),女,海南海口人,海南省农垦总医院 医师,医学学士,从事临床麻醉学研究。

Effects of different doses of ketamine on rocuronium induced injection pain and cardiovascular responses

  1. Department of Anesthesiology, Land Reclamation General Hospital, Hainan Province, Haikou 571100, China
  • Online:2016-05-25 Published:2016-05-20

摘要: [摘要] 目的 探讨不同剂量氯胺酮对罗库溴铵静脉注射痛反应及心血管反应的影响。方法 选择全身麻醉
气管插管手术患者 160 例,采用随机数字表法分为 4 组, A 组预注生理盐水 2mL , B 组预注 0.1mg /
kg
氯胺酮
2mL , C 组预注 0.2mg /
kg
氯胺酮 2mL , D 组预注 0.3mg /
kg
氯胺酮 2mL , 30s 后静脉注射 10mg 罗库溴铵。记
录入室后 10min 作为基础值,诱导药物注射完毕后 0min 、 1min 、 2min 及插管后 0min 、 1min 、 3min 的平均动脉
压( meanarterypressure ,
MAP )、收缩压( systolicbloodpressure , SBP )、舒张压 diastolicbloodpressure , DBP )、心率
( heartrate , HR )。使用 Chiarella 法判定注射痛。结果 4 组间注射痛发生情况差异有统计学意义( P <0.01 )。 C
组及 D 组注射痛发生情况明显低于 A 组, D 组注射痛发生情况显著低于 B 组( P <0.05 )。 4 组 MAP 、 SBP 、 DBP 均
呈先降低后升高的趋势, HR 呈逐渐升高的趋势,且随着药物剂量的增大,变化幅度明显减小,组间、时点间、组间·
时点间交互作用差异均有统计学意义( P <0.05 )。结论 预注氯胺酮可减缓罗库溴铵的注射痛,并且与注射剂量相
关。随着剂量加大,血流动力学指标更稳定,不良反应更小,值得临床推广应用。

关键词: 疼痛, 氯胺酮, 罗库溴铵

Abstract: [ Abstract ] Objective Toinvestigatetheeffectsofdifferentdosesofketamineonrocuronium
inducedinjectionpainandhemodynamicresponseduringanesthesiainduction.Methods One
hundredandsixtycasesoftrachealintubationpatientswererandomlydividedintofourgroups :
normalsaline2 mL ( group A ), injection0.1 mg / kgketamine2 mL ( groupB ), 0.2 mg /
kg
ketamine2 mL ( groupC ), 0.3 mg / kgketamine2 mL ( group D ) .Afterpretreatmentwith
experimentaldrugbydoubleblindedmethods , 10mgofrocuronium wasthenadministered30s
later.Thepainseveritywasscoredaccordingtothescaleoffourpointchiarella.Hemodynamic
parameterswerethencollectedatbaselineat0 min , 1 min , 2 minfollowinginjectionofall
anesthetics , aswellasat0 min , 1 min , 3 minaftertrachealintubation.Results Therewas
significantdifferenceintheincidenceofinjectionpainbetweenthe4groups ( P <0.01 ) .The
incidenceofinjectionpainingroupCandgroupDwassignificantlylowerthanthatingroupA
(
P <0.05 ) .TheincidenceofinjectionpainingroupDwassignificantlylowerthanthatingroup
B ( P <0.05 ) .The4groupsofpatientswith MAP , SBP , DBP werefirstdecreasedandthen
increased.HRshowedagraduallyincreasingtrend.Andwiththeincreaseofthedosageofthe drug , thechangerangewassignificantlydecreased.Thereweresignificantdifferencesinthe
interactionbetweenthegroups , thetimepointandthetime between groups ( P <0.05 ) .
Conclusion Pretreatmentwithketaminecanrelievetheinjectionpaininducedbyrocuronium
dosage-dependently.Withtheincrease ofthe dose , hemodynamics was morestable , side
reactionswasless.Itisworthyofclinicalapplication.

Key words: pain, ketamine, rocuronium