Preemptive effect of fentanyl and ketamine on postoperative pain and wound hyperalgesia.
Preemptive effect of fentanyl and ketamine on postoperative pain and wound hyperalgesia.
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芬太尼和氯胺酮对术后疼痛和伤口痛觉过敏的先发作用。
DOI：
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发表时间：
1994
影响因子：
5.7
通讯作者：
P. Bridenbaugh
中科院分区：
文献类型：
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作者：
M. Tverskoy;Yuval Oz;Alexander Isakson;J. Finger;E. Bradley;I. Kissin;P. Bridenbaugh
本研究的目的是验证芬太尼或氯胺酮诱导和维持麻醉的假设，即超过这些药物的直接镇痛作用可以解释这些作用的时间，芬太尼或氯胺酮可以减少术后疼痛和伤口痛觉过敏。在一项双盲随机研究中，对27例计划择期子宫切除术的患者进行了调查。患者分为三组。芬太尼组以芬太尼5微克/kg联合硫喷妥3 mg/kg诱导麻醉，异氟醚和芬太尼0.02微克/kg -1 min-1维持麻醉。氯胺酮组以氯胺酮2 mg/kg联合硫喷妥3 mg/kg诱导麻醉，异氟醚和氯胺酮20微克（kg-1 min-1）维持麻醉。对照组采用硫喷妥钠5 mg/kg诱导麻醉，仅用异氟醚维持麻醉。三组患者均接受相同的术后疼痛治疗。自发切口疼痛和运动相关疼痛的强度用视觉模拟自评法测量。采用疼痛计测量创面的痛阈压力和视觉模拟自评法测量创面的痛阈压力强度来评估手术创面痛觉过敏。术后48 h，对照组疼痛阈值为0.90 +/- 0.06 kg，芬太尼组为1.69 +/- 0.19 kg (P < 0.001)，氯胺酮组为1.49 +/- 0.15 kg （P < 0.01）。（摘要删节250字）
The aim of this study was to test the hypothesis that the induction and maintenance of anesthesia with the use of fentanyl or ketamine reduces postoperative pain and wound hyperalgesia beyond the period when these effects can be explained by the direct analgesic action of these drugs. Twenty-seven patients scheduled for elective hysterectomy were investigated in a double-blind, randomized study. Patients were divided into three groups. In the fentanyl group, anesthesia was induced with fentanyl 5 micrograms/kg combined with thiopental 3 mg/kg and maintained with isoflurane and fentanyl 0.02 microgram.kg-1.min-1. In the ketamine group, anesthesia was induced with ketamine 2 mg/kg in combination with thiopental 3 mg/kg and maintained with isoflurane and ketamine 20 micrograms.kg-1.min-1. In the control group, anesthesia was induced with thiopental 5 mg/kg and maintained with isoflurane only. Patients in all three groups received identical postoperative pain treatment. The intensity of spontaneous incisional pain and movement-associated pain was measured with a visual analog self-rating method. The surgical wound hyperalgesia was assessed by measuring pain threshold to pressure on the wound by using an algometer, and also by measuring the intensity of pain to suprathreshold pressure on the wound with the visual analog self-rating method. Forty-eight hours after surgery, the pain threshold was 0.90 +/- 0.06 kg in controls, 1.69 +/- 0.19 kg (P < 0.001) in the fentanyl group, and 1.49 +/- 0.15 kg (P < 0.01) in the ketamine group.(ABSTRACT TRUNCATED AT 250 WORDS)