曲马多布比卡因治疗前列腺切除术后疼痛  

Postoperative analgesia of tramadol and bupivacaine after prostatectomy

作　　者：贺从戎[1] 陈山[1] 焦志友[1] 张光银 

机构地区：[1]北京同仁医院泌尿外科

出　　处：《临床泌尿外科杂志》1999年第7期298-300,共3页Journal of Clinical Urology

摘　　要：目的：探讨曲马多、布比卡因混合液持续硬膜外腔注入治疗前列腺切除术后疼痛的疗效。方法：选择４０例前列腺增生症（ＢＰＨ）患者，随机分为两组，均于连续硬膜外麻醉下行耻骨上经膀胱前列腺切除术，术后留置硬膜外管４８ｈ。实验组采用曲马多、布比卡因混合液持续硬膜外注入，对照组采用单纯曲马多间断注入。两组曲马多总量一致。观察两组ＶＡＳ测痛评分，膀胱痉挛次数、持续时间，停止冲洗时间等。结果：实验组较对照组具有镇痛效果平稳，膀胱痉挛次数少、持续时间短、发生率低，不良反应少等特点，但术后恢复指标两组无显著性差异。结论：曲马多、布比卡因混合液持续硬膜外腔注药用于前列腺切除术后镇痛，与单纯曲马多硬膜外腔注药相比，具有镇痛效果平稳、不良反应少等优点。Purpose: The analgesic effects of continuous infusion of tramadol and bupivacaine mixture into epidural space after prostatectomy were evaluated. Methods: 40 cases of benign prostate hypertrophy were selected and at random divided into two groups,which were indwelled epidural catheter for 48 hrs postoperatively after suprapubic prostatectomy under continuous epidural anaesthesia.Continuous infusion of tramadol and bupivacaine was adopted in the experiment group,intermittent infusion of tramadol only in the control group.Under the condition of equal dose of tramadol,VAS,frequency and duration of bladder spasm,time for discontinuance of bladder instillation were observed. Results: The experiment group is superior to the control group with characteristics of stable analgesic effect,short duration and low frequency of bladder spasm,unusual adverse reactions, but no significant differences can be found in the indices for postoperative recovery in both groups. Conclusions: Postoperative analgesia of continuous infusion of tramadol and bupivacaine into epidural space has the advantages of stable analgesic effect and unusual adverse reactions as compared with tramadol only.

关 键 词：前列腺增生 手术后 止痛 曲马多 布比卡因 

分 类 号：R697.320.5[医药卫生—泌尿科学] R441.1[医药卫生—外科学]