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目的 :从临床角度研究氯胺酮在人体有无外周性镇痛作用 ,并探讨其可能的作用机理.方法 :将患者随机分为四组 :Ⅰ组为生理盐水组 ,Ⅱ组为氯胺酮组 ,Ⅲ组为氯胺酮 +纳洛酮组 ,Ⅳ组为氯胺酮 +生理盐水组.用改进的止血带法进行疼痛刺激 ,分别在注射前、注射氯胺酮后 5分钟、注射纳洛酮或生理盐水后 5分钟三个时点以视觉模拟评分法 (VAS)进行疼痛评分.结果 :注射氯胺酮后 5分钟与注射前相比 ,有明显的镇痛作用 (P“,”Objective:Tostudywhetherornotketaminehasperipheralanalgesiainhuman .Methods :Patientswereran domlydividedintofourgroups:groupⅠ ,thenormalsalinegroup ;groupⅡ ,theketaminegroup ;groupⅢ ,theketaminenaloxonegroup ;groupⅣ ,theketamine 0 9%sodiumchloride.Theimprovedhemostasiswithtourniquetwasusedtoinduce pain .Visualanalogscore(VAS)wasusedtoassesspainatthethreepointsofbeforeandafter 5minofsubcutaneousketamine injectionandafter 5minofsubcutaneousnaloxoneorinjection 0 9%sodiumchloride.Results:Thepatientshadanotable analgesiaaftertheinjectioncomparedtothatbefore (P <0 0 1) .Theanalgesiaofketaminecouldbepartlyantagonizedbyin jectionofnaloxone .Conclusion :Ketaminehasperipheralanalgesiainhuman ,indicatingthatketamineinsmalldosemightbe usedfortreatmentofperipheralpain .