曲马朵预防急性阑尾炎手术患者围术期寒战的效果观察  

Preventive effect of perioperative shivering with tramadol in patients with acute appendicitis

作　　者：蒋巧芬[1] 刘玲[1] 章冰玉 李珂休 

机构地区：[1]江苏省昆山市第三人民医院麻醉科,215300

出　　处：《实用疼痛学杂志》2010年第4期260-262,共3页Pain Clinic Journal

摘　　要：目的观察曲马朵预防急性阑尾炎患者围术期寒战和预先镇痛的效果。方法选择在连续硬膜外麻醉下行阑尾切除的患者100例，随机分为4组，每组25例。麻醉起效后，A、B、c组分别静脉注射曲马朵1、1．5、2mg／kg；D组给予生理盐水2ml。术毕前，A、B、C3组均静脉滴注曲马朵2mg／kg、格拉司琼3mg，加生理盐水500ml。D组静脉滴注生理盐水500ml。观察围术期患者呼吸循环的变化、术后镇痛效果，记录寒战、恶心呕吐的发生率等。结果4组患者呼吸循环变化差异无统计学意义（P〉O．05）；A、B、C组寒战发生率及程度显著低于D组；A、B、C三组术后镇痛情况良好，首次疼痛触发时间明显延长，与其他组相比，B组患者满意度最高。结论曲马朵1．5mg／kg术中静脉推注可有效预防阑尾切除术围术期寒战反应，术毕前静脉滴注2mg／kg，具有良好的术后镇痛作用。Objective To investigate the effect of tramadol for prevention of perioperative shivering and preemptive analgesia in acute appendicitis. Methods One hundred patients scheduled for appendectomy under continuous epidural anesthesia were randomly divided into four groups （n= 25）. After the onset of anesthesia, tramadol 1 mg/kg in group A,tramadol 1.5 mg/kg in group B, tramadol 2 mg/kg in group C, and normal saline 2 ml in group D were given intravenously to the patients. Before the end of operation, tramadol 2 mg/kg, granisetron 3 mg plus normal saline 500 ml in groups A, B, C and normal saline 500 ml in group D were dripped intravenously. The changes of respiration and circulation, the effect of postoperative pain relief and the rates of shivering, nausea and vomiting were observed. Results It were no significant differences in the changes of respiration and circulation between four groups（P〉0.05）. The incidence and degree of shivering in groups A, B, C were lower than that in group D. Postoperative analgesia was good in groups A, B, C and group B was most satisfied compared with others. Conclusion Tramadol 1.5 mg/kg intravenous in- jection is effective in preventing perioperative shivering during appendectomy. Also tramadol 2 mg/kg intravenous injection before the end of surgery is a valuable method to reduce postoperative pain.

关 键 词：曲马朵 阑尾炎 寒战 预先镇痛 

分 类 号：R473.6[医药卫生—护理学]