术前服用加巴喷丁对胃癌患者术后曲马多镇痛的影响  

Effect of gabapentin on tramadol postoperative analgesia after gastric cancer operations

作　　者：瞿慧[1] 王春光[1] 封小美[1] 胡益明[1] 段满林[1] 徐建国[1] 

机构地区：[1]南京大学医学院临床医院南京军区南京总医院麻醉科,210002

出　　处：《临床麻醉学杂志》2007年第9期725-727,共3页Journal of Clinical Anesthesiology

摘　　要：目的评价加巴喷丁对胃癌患者术后曲马多镇痛效果的影响。方法40例ASAⅠ或Ⅱ级择期行胃癌根治术的患者,随机分为观察组和对照组。观察组在术前2.5h单次口服加巴喷丁1200mg,对照组口服安慰剂。两组均以电子镇痛泵行曲马多PCIA。镇痛模式为患者自控镇痛(PCA)剂量20mg,锁定时间10min;1h后若镇痛效果不满意,PCA剂量改为30mg,每小时用量不超过120mg。镇痛期间行视觉模拟评分(VAS),记录术后1、4、8、12、16、20、24h心率(HR)、平均动脉压(MAP)、呼吸次数(RR)和曲马多用量。结果VAS观察组明显低于对照组(P<0.05);且观察组24h内曲马多用药量为(317.5±69.6)mg,明显少于对照组(576.5±106.2)mg(P<0.01)。两组患者不良反应的发生率差异无统计学意义。结论加巴喷丁明显减轻患者术后疼痛,显著减少PCIA曲马多的用量且并不增加不良反应的发生率,可作为超前镇痛药物的选择。Objective To investigate the effect of gahapentin on postoperative analgesia with tramadol in patients after gastric cancer operations. Methods Forty patients（ASA Class Ⅰ or Ⅱ ） underwent gastric cancer operations were randomly allocated to either test group or control group with 20 cases each. The patients in test group were given gahapentin 1 200 mg at 2.5 h before the surgery. In control group, oral placebo was given instead of gahapentin. All patients received PCA with tramadol with a 50 mg initial loading dose, 20 mg incremental dose, 10 min lockout interval, and 1 h limit of 120 mg. The incremental dose of 30 mg was alternated if analgesia was inadequate 1 h later. VAS scores,heart rate （ HR）, mean blood pressure （ MAP）, respiratory rate （RR） and total use of tramadol were recorded at 1,4, 8, 12, 16, 20, 24 h after surgery. Results The VAS scores were significantly lower in test group than those in control group（P〈0.05）. The total dosage of tramadol of test group was（317.5±69.6） mg, which was significantly less than that of the control（576.5±106.2）mg（P〈0. 01）. There were no significant differences in HR, MAP, RR and adverse effects between two groups. Conclusion Preemptive use of gahapentin can enhance postoperative analgesia with trarnadol in patients after gastric cancer operations.

关 键 词：加巴喷丁 曲马多 镇痛 

分 类 号：R614[医药卫生—麻醉学]