曲马多复合咪唑安定术后静脉病人自控镇痛效果观察  

CLINICAL OBSERVATION OF THE EFFECTS OF INTRAVENOUS PATIENT CONTROLLED ANALGESIA WITH TRAMADOL AND MIDAXOLAM IN POSTOPEEATIONS

作　　者：王礼彬[1] 黄乐林[2] 熊海虎[1] 余瑜[2] 李宜红[2] 

机构地区：[1]九江学院附属医院麻醉科 [2]解放军171医院麻醉科,江西九江332000

出　　处：《九江学院学报（自然科学版）》2004年第3期45-48,共4页Journal of Jiujiang University：Natural Science Edition

摘　　要：目的 :研究曲马多 -咪唑安定术后静脉镇痛的临床效果及安全性。方法 :将 90例手术后病人随机分成A组 (曲马多溶液 )、B组 (曲马多 +氟哌利多溶液 )及C组 (曲马多 +咪唑安定溶液 ) 3组 ,各 30例。进行病人 4 8h自控镇痛 ,记录镇痛后 4h、 8h、 12h、 2 4h、 4 8h各时间点的疼痛及镇静评分 ,监测HR、RR、SBP、DBP及SPO2 ,记录不良反应并计算各病人 4 8h镇痛液用量。结果 :C组镇痛液用量最少 ,与A组、B组比较 ,p <0 . 0 1;同一时间点疼痛及镇静评分与A组、B组比均有统计学意义 (p <0 . 0 1,0 . 0 5 ) ;A、B、C 3组镇痛优良率分别为 6 0 %、 73%、 93. 3% ,轻中度镇静率分别为 30 %、6 0 %、 93. 3%。C组与A组、B组比较差异均有统计学意义 (p <0 . 0 5 ) ,恶心、呕吐、尿潴留、嗜睡、呼吸抑制等发生率组间比均无显著统计学意义 (p >0 . 0 5 )。结论 :曲马多复合咪唑安定PCIA可明显减少曲马多用量 ,并获得良好的镇痛镇静效果 ,安全性高 ,不良反应少 ,可作为硬膜外自控镇痛 (PCEA)的一种方式 ,值得推广。OBJECTIVE To observe the effectiveness and safety of intravenous patient controlled analgesia(PCA)with tramadol and Midazolam in postoperations.Methods:Ninty patients were eandomly allocated to group A of tramadol (m=30),grope B of tramadol and Droperidol(m=30),grope C of tramadol and Midazolam(m=30),the PCA treatments were administrated on each patient during first forty eight hours of postoperations,the pain scores and sedation scores were measured at the time of 4h.8h.12h.24h.48h.respectively .Forthermore ,HR,RR,SBP,DBP,SPO2 and side effects of analgesia were measured or observed ,And the average dosages if the treatment drugs of each case in 48 hour were calculated.Results:The usages of the treatment drugw in group Cwere significantly less than the other two geoups(p<0.01).The pain scores and sedation scores at each the same dot were different among the three groups(p<0.01,0.05).The good rate of effectivity was 60%in group A,73.3% in group B and 93.3% in group Crespectively.The sedation rates of low to medium were 30%.60% and 93.3%.in group A,group B and group Crespectively.No significant differences in occurrence rates of other side effects of analgesics and postoperative complications were found among the three groups,(P>0.05). conclusion:Intravenous patient controlled analgesia with tramadol plus Midazolam for postoperation pain relief and sedation is effective and safe and the dosage of tramadol in group C could also have been obviously reduced.

关 键 词：曲马多 咪唑安定 病人术后自控镇痛 硬膜外自控镇痛 镇痛效果 静脉 

分 类 号：R619[医药卫生—外科学] R971.2[医药卫生—临床医学]