Cunningham B L, McKinney P
Plast Reconstr Surg. 1983 Jul;72(1):22-6. doi: 10.1097/00006534-198307000-00005.
A prospective study was undertaken to evaluate the efficacy, safety, and patient acceptance of low-dose ketamine when used to diminish the pain of local anesthetic injections. The role of diazepam in preventing the untoward psychological effects of ketamine was also investigated. Our findings, derived from a postoperative questionnaire, reinforce the assertions of others, that ketamine is safe and effectively prevents pain in 85 percent of patients. While 13 percent of our patients hallucinated, most found the experience pleasant, and there were no "bad trips" or emergence reactions. Adequate premedication appears to be important in the successful use of ketamine. Whether sedation is augmented with diazepam or achieved with other medications does not appear to matter. A close supportive relationship with the surgeon and operating room personnel is probably as important as any pharmacologic manipulation in avoiding psychological mishap with low-dose ketamine.
一项前瞻性研究旨在评估低剂量氯胺酮用于减轻局部麻醉注射疼痛时的疗效、安全性及患者接受度。同时还研究了地西泮在预防氯胺酮不良心理效应方面的作用。我们通过术后问卷调查得出的结果，进一步证实了其他人的观点，即氯胺酮是安全的，能有效预防85%患者的疼痛。虽然我们有13%的患者出现幻觉，但大多数人觉得这种体验不错，且没有“糟糕的幻觉之旅”或苏醒反应。充分的术前用药似乎对氯胺酮的成功使用很重要。地西泮是否增强镇静效果或使用其他药物达到镇静效果似乎并不重要。与外科医生及手术室工作人员建立密切的支持关系，在避免低剂量氯胺酮导致心理问题方面可能与任何药物操作同样重要。
