吗啡与曲马多用于上腹部手术术后静脉镇痛的效果观察  

Analgesic effects of Morphine with tramadol for upper abdominal surgery

作　　者：秦丽文[1] 郑良杰[1] 郝国明[1] 张舟[1] 张长椿[1] 

机构地区：[1]汕头市中心医院(中山大学附属汕头医院)麻醉科,广东汕头515031

出　　处：《国际医药卫生导报》2006年第16期87-89,共3页International Medicine and Health Guidance News

摘　　要：目的比较吗啡与曲马多用于上腹部手术术后静脉镇痛的效果。方法60例上腹部手术病人随机分为吗啡组(M组n-30)和曲马多组(T组n-30)。吗啡组(M组)背景输注吗啡0.01mg·kg-1·h-1+芬太尼0.1μg·kg-1·h-1,单次给药量吗啡0.5mg+芬太尼5μg;曲马多组(T组)背景输注曲马多0.2mg·kg-1·h-1+芬太尼0.1μg·kg-1·h-1,单次给药量曲马多5mg+芬太尼5μg;锁定时间均为10min。术后6、12、24、36、48h分别观察BP、HR、RR、VAS以及恶心、呕吐、镇静评分。结果两组BP、HR、RR、VAS评分无显著性差异;术后48h平均按压有效次数T组(15.5±3)次,M组(17.4±3)次,组间对比无显著性差异(P>0.05);术后48h,恶心、呕吐的发生率T组高于M组,组间对比有显著性差异(P<0.05);镇静作用强度M组高于T组,组间对比有显著性差异(P<0.05)。结论曲马多和吗啡用于上腹部手术术后静脉镇痛可提供同样满意的镇痛效果,曲马多恶心、呕吐的发生率高,而吗啡的镇静作用发生率高,需做出相应处理。Objective To compare the postoperative intravenous analgesic effect between tramadol and morphine for pain relief following upper abdomimal surgery.Methods 60 patients undergoing upper abdomimal surgery were randomly divided into group morphine（group M,n=30）and group tramadol（group T,n=30）.The infusing background of group M was morphine 0.0lmg·kg^-·h^-l fentanyl 0.1μg·kg^-l·h^-1 and single dose was morphine 5 mg^＋ fentanyl 5μg. The infusing background of group T was tramadol 0.2mg·kg^-1· h^-l fentanyl 0.1 μg·kg^-1·h^-1 and single dose was morphine 5 mg^＋ fentanyl 5μg. The lock time was 10min in both groups. The BP、 HR、 RR、 VAS and nausea, vomiting, sedation score at 6, 12, 24, 36, 48h of postoperation was recorded. Result There was no significantly difference of BP、 HR、 RR、 VAS between two groups. The average effective-press times during 48 hours of postoperation in group T were 15.5±3 and those were 17.4±3 in group M, There was no significantly difference between two groups. The frequency of nausea,vomiting in group T was higher than that in group M and the intensity of sedation in group M was stronger than that in group T, it was significantly difference between two groups. Conclusion Tramadol and morphine can afford the same satisfied analgesic effect upper for abdomimal surgery It needs deal with high nausea-vomiting frequency of tramadol and sedation of morphine

关 键 词：吗啡 曲马多 手术后 术后静脉自控镇痛 

分 类 号：R614[医药卫生—麻醉学]