曲马多在腹腔镜胆囊切除术患者术后镇痛的应用

目的观察腹腔镜手术患者单次静脉注射曲马多的术后镇痛效应。方法40例患者随机分为曲马多组（Ⅰ）和对照组（Ⅱ）,每组20例。患者选用吸入全麻,在术毕前,Ⅰ组静脉推注曲马多2.5mg/kg,稀释至10ml,时间长于5min;Ⅱ组同法推注10ml生理盐水。监测记录术前（T0）、拔管时（T1）、术后2h（T2）、4h（T3）、8h（T4）、12h（T5）患者循环呼吸功能,VAS及OAA/S评分,苏醒时间,T0、T2时患者血糖及不良反应。结果2组患者MAP、HR、RR、SpO2和苏醒时间、恶心呕吐发生率无显著差异,Ⅰ组VAS及OAA/S镇静评分在T1、T2、T3与Ⅱ组比较均有极显著性差异;Ⅱ组血糖在T2时显著高于Ⅰ组。结论腹腔镜胆囊切除术的患者使用曲马多2.5mg/kg,术后镇痛效果明显,应激反应轻,副作用少,值得临床应用。

Application of Tramadol for Postoperative Analgesia in Patients with Laparoscopic Cholecystectomy

Objective To observe the postoperative analgesic effect of tramadol in patients with single intravenous injection undergoing laparoscopic cholecystectomy. Methods Forty patients were randomly divided into two groups： the tramadol group（ Ⅰ ） and control group（ Ⅱ） ,20 cases each. All patients received inhalation anesthesia. At the end of operation,group Ⅰ administrated with intravenous injection of tramadol 2.5 mg/kg. The solution diluted to 10 ml. The time of injection was longer than 5 min. And group Ⅱ administrated with intravenous injected 10 ml physiological saline solution. The circulation and respiratory function, VAS and OAA/S scores at preoperative （ TO ） , extubation （ T1 ） , after operation 2 （ T2 ） , 4 （ T3 ） , 8 （ T4 ） , 12 hours （ T5 ） , and recovery time,blood glucose and adverse reactions were recorded. Results There was no difference in MAP, HR, RR, SpO2 and recovery time,the incidence of nausea and vomiting between the two groups. But it was very significant VAS and OAA/S sedation score at T1 ,T2 ,T3 between two groups. The blood glucose was significantly increased at T2 in the group Ⅱ. Conclusions The postoperative analgesic effect of tramadol is obviously in patients undergoing laparoscopic cholecystectomy with light stress response and less side effects.