曲马多用于急性创伤后镇痛的研究  

Research of Tramadol's analgesic effect on acute posttraumatic pain

作　　者：隋波[1] 谢厚云[1] 苏冬梅[1] 马玉恒[1] 田雷[1] 孙潮涌[1] 王维[1] 马涛[1] 

机构地区：[1]第二炮兵总医院麻醉科,北京100088

出　　处：《临床急诊杂志》2009年第3期136-138,共3页Journal of Clinical Emergency

摘　　要：目的:探讨曲马多用于急性创伤后镇痛的可行性。方法:将80例成年人肢体骨折患者随机分为2组,即曲马多组和吗啡组,在患者被送到急诊室后监测生命体征在正常范围,方可静脉注射盐酸曲马多注射液100mg或盐酸吗啡注射液5mg,用药30min后用4点法口述等级评分测定疼痛强度,同时用4点法测定镇静等级。结果:曲马多组和吗啡组Ⅲ级疼痛患者的百分数分别从47.5%和52.5%降至0,有统计学意义(P<0.05);Ⅱ级疼痛患者的百分数分别从47.5%和45.0%降至22.5%和27.5%,有统计学意义(P<0.05);Ⅰ级疼痛患者的百分数分别从5.0%和2.5%升至67.5%和65.0%,有统计学意义(P<0.05);0级疼痛患者的百分数分别从0升至10.0%和9.0%,有统计学意义(P<0.05)。曲马多组和吗啡组的0级镇静的百分数分别从90.0%和92.5%降至12.5%和10.0%,有统计学意义(P<0.05);Ⅰ级镇静的百分数分别从10.0%和7.5%升至77.5%和75%,有统计学意义(P<0.05);Ⅱ级镇静的百分数分别从0升至10.0%和15.0%,有统计学意义(P<0.05)。2组镇痛效果的差异与镇静效果的差异均无统计学意义。结论:曲马多可替代吗啡用于创伤后镇痛。Objective：To discuss the Tramadol＇s analgesia action on acute posttraumatic pain. Method：Eighty adult patients with limb fractures were randomly divided into 2 groups （the Tramadol group and the Morphine group） . The vital signs of all patients were in the normal range. The patients were intravenous injection with tra- madol 100mg or morphine 5mg. All the patients were asked to assess the intensity of their pain by using four-point verbal rating scale. The sedation was also assessed by the emergency physician with a four-point rating scale before and 30 min after treatment. Result： The results showed that the percentage of patients with 3 point pain of group T and group M each from 47.5% and 52.5% decrease to 0%（ P 〈0.05）. the percentage of patients with 2 point pain of group T and group M each from 47.5 % and 45 % decrease to 22.5 % and 27.5 % （ P 〈0.05）. The percentage of 1 point pain patients of group T and group M each from 5% and 2.5% increase to 67.5% and 65%（P〈0.05）. The percentage of 0 point pain patients of group T and group M each from 90% increase to 10% and 9%（ P 〈0.05）. The percentage of 0 point sedation patients of group T and group M each from 90% and 92. 5% decrease to 12.5% and 10%（ P 〈0.05）. The percentage of 1 point sedation patients of group T and group M each from 10% and 7.5% increase to 77.5% and 75% （ P 〈0： 05）. The percentage of 2 point sedation patients of of group T and group M each from 0 increase to 10 % and 15 % （ P 〈0.05）. Conclusion： These data suggested that Tramadol was an acceptable alternative to morphine for treating posttraumatic pain.

关 键 词：曲马多 创伤 镇痛 

分 类 号：R654.2[医药卫生—外科学]