曲马多联合氟哌利多应用于耳鼻喉手术的临床观察

目的：探讨曲马多联合氟哌利多应用于耳鼻喉手术的镇痛效果及安全性。方法选取2012年4月至2013年4月在我院接受耳鼻喉手术的70例患者为研究对象，随机分为观察组36例与对照组34例，观察组应用曲马多联合氟哌利多治疗，于手术开始局麻前静脉注射曲马多3 mg/kg和氟哌利多0.04 mg/kg，并使用微量泵持续输注二者的混合液约24h；对照组患者使用利多卡因进行常规的局部麻醉。观察记录两组患者术后1h、4h、8h、12h的疼痛视觉模拟评分（VAS）分值，麻醉剂注入前（T0）、注入后（T1）、手术开始（T2）、手术结束（T3）的血流动力学变化及不良反应。结果观察组患者疼痛程度在术后1h、4h、8h的VAS评分明显低于对照组，差异有显著统计学意义（P〈0.01），术后12 h与对照组比较差异无统计学意义（P〉0.05）；对照组患者的SBP、DBP、HR指标比观察组波动幅度大，观察组的麻醉效果比对照组稳定；观察组术后不良反应的总发生率（8.33%）也明显低于对照组（23.53%）， P〈0.05。结论曲马多联合氟哌利多应用于耳、鼻、喉手术的镇痛效果好，能有效提高患者生活质量，值得临床推广使用。

Clinical observation of the application of tramadol combining droperidol in ENT Surgery

Objective To investigate the analgesic effect and safety of tramadol combining droperidol in ENT surgery. Methods Seventy patients accepted ENT surgery were divided into observation group （36 cases） and control group （34 cases） randomly. The former were treated with tramadol （3 mg/kg） combined with droperidol （0.04 mg/kg） five minutes before starting ENT surgery, and the latter received conventional local anesthesia. Pain visu-al analogue scale （VAS） scores 1 h, 4 h, 8 h, 12 h after surgery, hemodynamic changes and adverse reactions before an-esthesia （T0）, after anesthesia （T1）, at the beginning of surgery （T2）, at the end of surgery （T3） were observed and statisti-cally analyzed. Results Compared with control group, the VAS scores 1 h, 4 h, 8 h after surgery of observation group were significantly lower （P〈0.01）, with no statistically significant difference 12 h after surgery （P〉0.05）. Chang-es in SBP, DBP, HR of the control group were larger, and the anesthetic effect of the observation group was more sta-ble. The incidence of adverse reactions after ENT surgery of observation group （8.33%） were significantly lower than 23.53%of the control group （P〈0.05）. Conclusion Tramadol combined with droperidol has significant analgesic ef-fect for ENT surgery and can improve the life quality of patients effectively.