曲马多用于全子宫手术后PCIA的效果评价

目的:将曲马多与传统的阿片类药物进行对比,对其静脉自控镇痛(PCIA)效果进行评估。方法:90例ASAⅠ~Ⅱ级的全子宫手术病人,随机分为三组,每组30例,曲马多组(T组):负荷剂量(Loding dose)1.5mg/kg,单次剂量(PCA bolus)10mg,背景输注(Back ground)10mg/h,锁定时间(Lockout time)5min;芬太尼组(F组):Loding dose1μg/kg,PCA bolus10μg,Back ground10μg/h,Lockout time5min;吗啡组(M组):Loding dose0.15mg/kg,PCA bolus0.5mg,Back ground1mg/h,Lockout time5min;观测患者24h内心率、血压、呼吸频率、脉氧饱和度、VAS、镇静评分、Prince Henry评分以及副作用的发生率,并记录患者24h内用药量。结果:SS、VAS、PHS三组病人无显著性差异(P>0.05);恶心呕吐的发生率T、M组>F组,差异有显著性(P<0.05);排气时间延长发生率F、M组>T组,差异有显著性(P<0.05)。结论:曲马多能够获得与吗啡、芬太尼相同的满意的镇痛效果,并且降低了术后排气时间延长的发生率,但恶心的发生率高于芬太尼组。

Evaluation of tramadol in postoperative patient——controlled intravenious analgesia (PCIA) for the patients after complete hysterectomy under general anesthesia

Objective:To compare tramadol with traditional opioids thus to evaluate the analgesic effect of tramadol.Methods:The subject were 90 patients (age 20~60 year) with ASA Ⅰ ~Ⅱ who accepted complete hysterectomy under general anesthesia. The patients were blindly randomized into three groups: Group tramadol (group T n=30): Loading dose 1.5 mg/kg, PCA bolus 10 mg, Background:10 mg/h, Lockout time 5 min; Group fentanyl (group F n=30).Loding dose 1 μg/kg, PCA bolus 101 μg, Background 10 μg/h, Lockout time 5 min; Group morphine (group M n=30): Loading dose 0.15 mg/kg, PCA bolus 0.5 mg, Background 1 mg/h, Lockout time 5 min;The heart rate, blood pressure, respiratory rate, pulse oxygen saturation, VAS, Sedation Score (SS), Prince Henry Score (PHS) of the patients as well as side effects were observed. Total consumption of analgesics within 24 hours was also recorded.Results:SS,VAS, and PHS showed no difference among three groups.The rates of postoperative nausea and vomit (PONV) of group T and group M were higher than that of group F (P<0.05);The rate of delayed exsuffiation in group F and group M were higher than that of group T (P<0.05).Conclusion:When used in postoperative PCIA, tramadol can provide the same and satisfied effect as that of morphine and fentanyl, accompanied with lower frequency of delayed exsuffiation. However, the rate of PONV in patients who accepted tramadol was higher than that in patients who accepted fentanyl.