Roytblat L, Korotkoruchko A, Katz J, Glazer M, Greemberg L, Fisher A
Division of Anaesthesiology and Intensive Respiratory Care, Soroka University Hospital, Beer-Sheva, Israel.
Anesth Analg. 1993 Dec;77(6):1161-5. doi: 10.1213/00000539-199312000-00014.
In a randomized, double-blind study, postoperative pain was assessed in 22 patients undergoing elective open cholecystectomy with two types of anesthesia: standardized general anesthesia (control group), and low-dose ketamine as an addition to the same method of general anesthesia, before surgical incision (ketamine group). After the operation we found that the time from the end of surgery to the first request for analgesic was longer in the ketamine group. Postoperatively, patients in both groups were treated with patient-controlled analgesia (PCA) in exactly the same way. The major difference in the study was the reduced dose requirement of morphine in the ketamine group compared with the control group after the operation. The mean dose of morphine given in patients of the control group during the first 24 h was 48.7 mg vs 29.5 mg in the ketamine group. Mean visual analog scale (VAS) and verbal rating scale (VRS) were higher in patients in the control group during the first 5 h after surgery (P < 0.02), but between 5 and 24 h after surgery VAS and VRS were not significantly different (P > 0.05). Our results indicate that postoperative pain can be decreased when ketamine in low doses is added to general anesthesia before surgical stimulation.
在一项随机双盲研究中，对22例行择期开腹胆囊切除术的患者在手术切口前采用两种麻醉方式评估术后疼痛：标准全身麻醉（对照组），以及在相同全身麻醉方法基础上加用小剂量氯胺酮（氯胺酮组）。术后我们发现，氯胺酮组从手术结束到首次要求镇痛的时间更长。术后，两组患者均采用完全相同的方式进行患者自控镇痛（PCA）。该研究的主要差异在于，术后氯胺酮组吗啡的剂量需求比对照组减少。对照组患者在术后最初24小时内吗啡的平均给药剂量为48.7毫克，而氯胺酮组为29.5毫克。术后最初5小时内，对照组患者的平均视觉模拟评分（VAS）和语言评定量表（VRS）更高（P<0.02），但术后5至24小时，VAS和VRS无显著差异（P>0.05）。我们的结果表明，在手术刺激前的全身麻醉中加用小剂量氯胺酮可减轻术后疼痛。
