【摘要】 目的 觀察在腹腔鏡膽囊切除術中，氯胺酮超前鎮痛對瑞芬太尼麻醉后急性疼痛的影響。 方法 2009年10月-2010年1月，將擇期行腹腔鏡膽囊切除術患者90例，隨機分為對照組（C組）、氯胺酮超前鎮痛組（K組）、氯胺酮術畢鎮痛組（K1組），每組30例。所有患者均采用瑞芬太尼復合丙泊酚靜脈麻醉，K組在切皮前靜脈給予氯胺酮0.5 mg/kg，K1組在關腹前靜脈給予氯胺酮0.5 mg/kg，C組不給予任何藥物。記錄術畢患者麻醉恢復情況，各時間點疼痛程度。 結果 K組、K1組躁動發生率均明顯低于C組（Plt;0.05）；術后2、4、8、24 h，K組VAS評分及鎮痛藥使用率明顯低于C組和K1組（Plt;0.05）。 結論 氯胺酮超前鎮痛能明顯降低瑞芬太尼術后疼痛，并且不增加并發癥發生率。【Abstract】 Objective To evaluate the preemptive analgesia of ketamine on remifentanil induced acute postoperative pain after laparoscopic cholecystectomy. Methods Ninty patients scheduled for laparoscopic cholecystectomy between october 2009 to Jannary 2010 were randomly assigned to three groups (n=30). Group K was administrated with 0. 5 mg/kg ketamine intravenously before skin incision, and Group K1 were administrated with 0. 5 mg/kg ketamine intravenously before abdominal closure, while Group C received nothing. The recovery and the side effects were recorded, the VAS at two, four, eight and 24 hours after surgery, and the use of anodyne were recorded. Results The incidence of restlessness in Groups K and K1 was remarkably lower than that of Group C (Plt;0. 05). The analgesic effects two, four, eight and 24 hours after surgery were obviously better in group K than those of Group C and Group K1 (Plt;0. 05). Conclusion Ketamine can produce preemptive analgesia to relieve remifentanil-induced acute pain, and it would not increase incidence of side effects.
ObjectiveTo systematically evaluate the efficacy of different non-pharmacological interventions in relieving acute pain after lung cancer surgery, and to provide high-level evidence-based basis for formulating precise analgesic nursing plans in clinical practice. MethodsSystematic searches were conducted in Chinese and English core databases including CNKI, Wanfang Data, VIP Database, CBM, PubMed, Embase, Cochrane Library, and Web of Science. Relevant randomized controlled trials (RCTs) published from the establishment of the databases to October 2025 were collected, with supplementary retrieval through reference tracing. Two researchers independently conducted literature screening and data extraction. The quality of the included literature was evaluated using the Cochrane risk of bias assessment tool, and a network meta-analysis was performed using Stata 18.0 software. ResultsA total of 34 RCTs involving 3019 postoperative lung cancer patients and 15 types of non-pharmacological interventions were included. Network meta-analysis showed that compared with conventional nursing, relaxation therapy [MD=?2.55, 95%CI (?3.66, ?1.44)], fire cupping combined with music therapy [MD=?2.32, 95%CI (?4.05, ?0.59)], psychological therapy [MD=?1.45, 95%CI (?2.05, ?0.85)], and transcutaneous electrical acupoint stimulation [MD=?1.38, 95%CI (?2.02, ?0.75)] had significant pain relief effects (all P<0.05). The surface under the cumulative ranking curve (SUCRA) analysis indicated that relaxation therapy was the optimal intervention (SUCRA=93.6%). ConclusionRelaxation therapy has the best effect in relieving acute pain after lung cancer surgery and can be used as the preferred option in clinical nursing. However, the conclusion still needs to be further verified by a large number of high-quality and large-sample RCTs.