小剂量曲马多复合液防治妇科术后疼痛疗效分析

目的:探讨小剂量曲马多复合液防治妇科术后疼痛疗效及不良反应。方法:选择妇科手术100例,随机分为两组,每组50例。采用腰麻-硬膜外联合麻醉,术毕关腹腔时经硬膜外导管注入0.25%布比卡因和5mg地塞米松的复合液5ml,然后连接一次性使用微量止痛泵行硬膜外腔自控镇痛(PCEA),容量100ml,持续流量2.0ml/h,自控剂量0.5ml/15min。复合液配方:A组为曲马多400mg加氟哌利多5mg加布比卡因187.5mg加地塞米松10mg加生理盐水至100ml。B组为曲马多600mg,其他同A组。评价术后镇痛效果与不良反应。结果:术后无痛和有轻度疼痛A组占96%,B组占98%,P>0.05。不良反应总发生率A组为30%,B组为52%,P<0.05。结论:400mg曲马多复合液防治妇科术后疼痛与600mg曲马多复合液比较疗效相当,不良反应明显减少,值得临床应用。

A small dose of tramadol combined with bupivacaine for postoperative pain relief in gynecology department

Objective:To evaluate the analgesic effects and side effects of tramadol combined with bupivacaine for postoperative pain control. Methods:100 gynecologic operative patients were rondomly divided into two groups. Both groups received combined spinal epidural anesthesia, a mixed 5 ml of 0.25% bupivacaine with dexamethasone 5 mg was injected epidurally at end of operation. Then patient controlled epidural analgesia (PCEA) was applied at a continuous epidural infusion of drugs at 2 ml/ hours with a total volume of 100 ml plus bolus dose 0.5 ml lockout time 15 min. PCEA medication: group A had tramadol 400 mg + droperidol 5 mg + bupivacaine 187.5 mg + dexamethasone 10 mg with normal saline diluted to 100 ml. Group B had tramadol 600 mg and other as group A. Postoperative analgesic efficacy and side effects were recorded. Results:Patients with no pain or minor pain in group A is 96% and that in group B is 98% (P>0.05). Side effects in group A is 30% and that in group B is 52% (P<0.05).Conclusion:400 mg tramadol mixed medication provided similar postoperative analgesia as 600 mg tramadol mixed medication but had less side effects.