不同剂量舒芬太尼复合曲马多用于妇科术后静脉自控镇痛

目的评价不同剂量舒芬太尼复合曲马多用于妇科术后静脉自控镇痛的效果。方法75例择期行妇科开腹手术的患者随机分为3组,A组：舒芬太尼50μg＋曲马多500 mg;B组：舒芬太尼100μg＋曲马多500 mg;C组：舒芬太尼150μg,3组镇痛药物均加入氟哌啶2.5 mg,用生理盐水稀释至100 ml。手术结束前连接PCA泵,镇痛模式为负荷剂量2 ml,持续剂量1.2 ml/h,PCA为2 ml,锁定时间20 min,全程观察24 h。分别于术后3-4 h、8-10 h、12-20 h、23-24 h访视记录患者VAS评分,镇痛药用量、PCA按压次数、Ramsay镇静评分和生命体征及不良反应。结果所有患者均获得满意的镇痛效果,无需添加其他的镇痛药物。术后24 h各时段B、C两组VAS评分均低于A组（P〈0.05或P〈0.01）,各时段B、C两组镇痛药用量明显少于A组（P〈0.05）,在34 h、810 h时间段PCA有效按压次数B、C两组明显低于A组（P〈0.05）;3组患者各时段Ramsay镇静评分未见明显差异,镇痛过程患者生命体征平稳,无明显副作用。结论舒芬太尼复合曲马多用于妇科开腹术后静脉自控镇痛,临床效果好,安全可靠。

Effect of sufentanil compounded tramadol at different dosage on postoperative controlled intravenous analgesia

Objective To assess the effect of sufentanil compounded tramadol at different dosage on postoperative controlled intravenous analgesia.Methods Seventy-five woman patients undergoing arranged abdominal gynecological operations were randomly divided into three groups,with 25 patients in each group.Group A： analgesia compounded drugs in PCIA were sufentanil 50 μg＋tramadol 500 mg;group B： sufentanil 100 μg＋tramadol 500 mg;group C： sufentanil 150 μg.Compounded drugs in each group were added droperidol 2.5 mg and diluted with normal saline to 100 ml.PCIA pumps were connected after the operations were finished.The PCIA pump was set as follows： load dosage 2 ml,continuous dosage 1.2 ml/h,PCA 2 ml,and locking time 20 min.The whole observing course was 24 h,evaluating pain degree at each period by using visual analogue scale（VAS）,meanwhile the PCA times,Ramsay grades,vital signs and side-effects were recorded.Results All the patients achieved satisfactory analgesia effect,no need for other analgesia drugs.In comparison with those in group A,VAS score and capacity of analgesia drugs of groups B and C significantly reduced at each analgesia period（P〈0.05 or P〈0.01）;whilst PCA effective time in groups B and C increased remarkably during the beginning 3-4 h and thereafter 8-10 h（P〈0.05）.No difference was detected among the three groups in Ramsay grades 24 h postoperatively.Vital signs remained stable at each analgesia period,without significant side effect.Conclusion Using sufentanil compounded tramadol in PCIA has the advantage of reduced dosage of analgesia drugs,good effect,and low side-effect incidence.