雷莫司琼预防宫外孕患者术后曲马多不良反应的临床观察

目的研究雷莫司琼对宫外孕患者行腹腔镜手术后曲马多不良反应的影响。方法选择在全麻下行腹腔镜手术的宫外孕患者90例,按照随机数字法分为A、B、C 3组,每组各30例。3组采用相同的麻醉诱导和麻醉维持方式,A组:全麻诱导前给予雷莫司琼0.3 mg,术后镇痛泵(曲马多1 000 mg+雷莫司琼0.3 mg);B组:全麻诱导前给予生理盐水,术后镇痛泵(曲马多1 000 mg+雷莫司琼0.6 mg);C组:全麻诱导前给予生理盐水,术后镇痛泵(曲马多1 000 mg+雷莫司琼0.3 mg)。分别记录3组术后6 h、12 h及24 h疼痛评分和胃肠道不良反应的发生率。结果 3组患者疼痛评分比较,差异无统计学意义(P0.05);胃肠道不良反应的发生率A组最低,差异有统计学意义(P0.05)。结论麻醉前诱导时给予雷莫司琼加术后镇痛泵中再次给予雷莫司琼,能够明显的降低宫外孕腹腔镜手术后应用曲马多镇痛的不良反应,提高患者的舒适度和满意度。

Clinical observation of prevention of postoperative adverse effect of tramadol using ramosetron in patient with extrauterine pregnancy

Objective To investigate the influence of ramosetron on adverse effect of tramadol in patient with laparoscopic ectopic pregnancy operation . Methods 90 cases of patients with laparoscopic eetopic pregnancy operation were performed general anesthesia. All cases were randomized into group A, group B and group C, with 30 cases in each group. Three groups used the same anesthesia induction and maintenance of anesthesia method. Group A ： Using ramosetron 0. 3 mg before induction of anesthesia, postoperative analgesia pump （ tramadol 1 000 mg＋ ramosetron 0. 3 mg）. Group B： Using normal saline before induction of anesthesia, postoperative analgesia pump （tramadol 1 000 mg ＋ ramosetron 0. 6 mg ）. Group C： Using normal saline before induction of anesthesia, postoperative analgesia pump （ tramadol 1 000 mg ＋ ramosetron 0. 3 mg）. Patients were evaluated based on the visualanalogue scale （VAS） and post -operative nausea and vomiting at three time points including 6 hours, 12 hours and 24 hours after the operation. Results There was no significant difference in VAS between the three groups （ P 〉 0.05 ）. The post - operative nausea and vomiting rate was significant lower in Group A than Group B and Group C （P 〈 0. 05 ）. Conclusion The ramosetron using before induction of general anesthesia and once more in postoperative analgesia pump can effectively reduce adverse effect of tramadol for patients with laparoscopic ectopic pregnancy operation, which can also improve patients＇ comfort level and satisfaction.