Buprenorphine vs.Ketamine for Postoperative Epidural Analgesia

OBJECTIVE:To evaluate the postoperative analgesic effects and side effects of buprenorphine versus ketamine for patients with patient-controlled epidural analgesia(PCEA).METHODS:60 patients withⅠ～Ⅱ grade in physical status evaluated by American society of anesthesiologists(ASA)scheduled for lower abdomen surgery by lumbar anesthesia combined epidural anesthesia were divided into three groups by a randomized double blind method to be treated with Buprenorphine + Droperidol(Group A),Buprenorphine + Droperidol + Bupivacaine(Group B),or Ketamine + Droperidol+ Bupivacaine(Group C).The visual analogous scale(VAS),Ramsay scale,frequency to press the analgesia pump was recorded at 0～48 h after operation,the time spent for the recovery of intestinal functions;score for nausea vomiting and other adverse drug reactions were observed.RESULTS:Frequency to press the analgesia pump,VAS score and Ramsay score in Group A in different period of time were all significantly different from those in Group B and Group C(P0.05);in terms of the time spent for the recovery of intestinal function,there were significant difference between Group A and the other two groups(Group B and Group C)(P0.05);there were significant differences among the three groups in incidence of nausea,skin pruritus and urine retention(P0.01).CONCLUSION:Combined local anethesia with buprenorphine and ketamine showed proved efficacy for patients undergoing PCEA;and ketamine was more effective in decreasing the incidences of nausea and vomiting and skin pruritus.