Epidural Ketamine for Postoperative Pain Relief after Gynecologic Operations: A Double‐Blind Study and Comparison with Epidural Morphine
Epidural Ketamine for Postoperative Pain Relief after Gynecologic Operations: A Double‐Blind Study and Comparison with Epidural Morphine
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硬膜外氯胺酮用于妇科手术后止痛：双盲研究及与硬膜外吗啡的比较
作者：
Y. Kawana;H. Sato;H. Shimada;N. Fujita;Y. Ueda;A. Hayashi;Y. Araki
本双盲研究评估了硬膜外给予氯胺酮是否有效缓解术后疼痛，并比较了硬膜外氯胺酮与硬膜外吗啡的效果。68例腹部妇科手术患者随机分为6组（对照组；氯胺酮4、6、8 mg生理盐水；10%葡萄糖6 mg；吗啡3 mg）。所有患者均以硫喷妥钠、氧化亚氮和苯乙醚麻醉，并在手术结束时硬膜外给药。氯胺酮组镇痛时间与对照组无明显差异，稀释剂的差异无明显影响。值得注意的是，吗啡组在24小时内没有患者需要额外的镇痛药，而其他五组中85%的患者需要。我们得出结论，硬膜外给予氯胺酮不足以缓解妇科手术后的疼痛。
This double-blind study evaluates whether ketamine given epidurally is effective for postoperative pain relief, and compares the effects of epidural ketamine with those of epidural morphine. Sixty-eight patients undergoing abdominal gynecologic surgery were randomly assigned into six groups (control; ketamine 4, 6, and 8 mg in saline; 6 mg in 10% glucose; morphine 3 mg). All patients were anesthetized with thiopental, nitrous oxide, and enfturane, and drugs were administered epidurally at the end of the operation. The duration of analgesia in the ketamine groups did not differ from that in control patients and the difference in diluent had no observable effects. Significantly, none of the patients in the morphine group needed additional analgesics within 24 hr, whereas 85% in the other five groups did. We conclude that ketamine administered epidurally is inadequate for postoperative pain relief after gynecologic operations.