Arıkan Müge, Aslan Bilge, Arıkan Osman, Horasanlı Eyüp, But Abdulkadir
School of Medicine, Karabuk University, Turkey.
Department of Anesthesiology, Zekai Tahir Burak Education and Research Hospital, Ankara, Turkey.
Acta Cir Bras. 2016 Jan;31(1):67-73. doi: 10.1590/S0102-865020160010000010.
To compare the effects of magnesium sulfate and ketamine on postoperative pain and total morphine consumption in a placebo-controlled design.
One hundred and twenty women scheduled for total abdominal hysterectomy were included in this prospective, randomized, double-blind study. Postoperatively, when the Numeric Pain Rating Scale (NPRS) was four or more, IV-PCA morphine was applied to all patients. The patients were randomized into three groups: Group K ketamine, Group M magnesium, and Group C saline received as infusion. Total morphine consumption for 48h, pain scores, adverse effects, and patients' satisfaction were evaluated.
Total morphine consumption was significantly lower in Group K (32.6±9.2 mg) than in Group M (58.9±6.5 mg) and in Group C (65.7±8.2 mg). The satisfaction level of patients in Group K was higher than the other two groups (p<0.05). Pruritus and nausea were observed more frequently in Group C. CONCLUSİON: The addition of ketamine to IV-PCA morphine reduces the total consumption of morphine without psychotic effects; however, magnesium did not influence morphine consumption.
在安慰剂对照设计中比较硫酸镁和氯胺酮对术后疼痛及吗啡总消耗量的影响。
本前瞻性、随机、双盲研究纳入了120例行全腹子宫切除术的女性患者。术后，当数字疼痛评分量表（NPRS）为4分或更高时，所有患者均给予静脉自控镇痛（IV-PCA）吗啡。患者被随机分为三组：K组（氯胺酮组）、M组（硫酸镁组）和C组（输注生理盐水组）。评估48小时内的吗啡总消耗量、疼痛评分、不良反应及患者满意度。
K组的吗啡总消耗量（32.6±9.2毫克）显著低于M组（58.9±6.5毫克）和C组（65.7±8.2毫克）。K组患者的满意度高于其他两组（p<0.05）。C组瘙痒和恶心的发生率更高。结论：在IV-PCA吗啡中添加氯胺酮可降低吗啡总消耗量且无精神症状影响；然而，硫酸镁对吗啡消耗量无影响。
