小剂量纳洛酮联合曲马多用于妇科腹腔镜术后镇痛的临床观察

目的：探讨小剂量纳洛酮联合曲马多用于妇科腹腔镜术后镇痛的效果。方法：选择行腹腔镜手术治疗的患者104例，随机分为曲马多组和联合组，各52例。曲马多组于腹腔镜术后给予曲马多100mg ，静注；联合组给予曲马多100mg ，纳洛酮0．4mg ，静注。结果：联合组在 T0、T1h 、T6h时VAS评分明显低于曲马多组（P＜0．05）。联合组术后T0、T1h 、T6h时MAP、HR均明显低于曲马多组（P＜0．05）。联合组术后24h恶心、呕吐发生率明显低于曲马多组。联合组术后2h寒战发生率明显低于曲马多组（P＜0．05）。结论：小剂量纳洛酮联合曲马多可增强曲马多的镇痛效果，降低其消耗量，对血流动力学影响较轻，不良反应少，安全可靠，对患者术后恢复非常有利。因此，曲马多联合小剂量纳洛酮对术后镇痛效果安全、有效，是腹腔镜术后镇痛较好的方法。

Clinical Observation of Tramadol Combined Low-dose Naloxone Applicating in Analgesia after Gynecological Laparoscopic Surgery

Objective：To investigate clinical effect of tramadol combined low-dose naloxone applicating in analgesia af-ter gynecological laparoscopic surgery .Methods：104 patients who was treated with laparoscopic operation were select-ed ,they were randomly divided into tramadol group and combined group ,there were 52 cases in each group .Tramadol group received intravenous injecting tramadol 100mg after laparoscopic surgery ;combination group received intravenous injecting tramadol 100mg and naloxone 0 .4mg .Results：The VAS score at T0 ,T1h ,T6h after operation in combination group were significantly lower than those in tramadol group （P〈0 .05） .The MAP ,HR at T0 ,T1h ,T6h after operation in combination group were significantly lower than those in tramadol group （P〈0 .05） .The nausea ,vomiting incidence at 24 hours after operation in combination group were significantly lower than those in tramadol group .The shiver inci-dence at 2 hours after operation in combination group was significantly lower than that in tramadol group（P〈0.05） . Conclusion：Low-dose naloxone combined with tramadol can enhance analgesic effect of tramadol ,reduce tramadol’s consumption ,hemodynamic effects is lighter ,it has less adverse reaction ,is safe and reliable ,is very beneficial to post-operative recovery of patients .Therefore ,low-dose naloxone combined with tramadol’s effect on theanalgesia is safety , effective ,it is a better analgesia after laparoscopic surgery .