酮咯酸复合曲马多超前镇痛对术后舒芬太尼静脉镇痛效果的影响  

Effects of preemptive ketorolac tromethamine combined with tramadol on postoperative analgesia of sufentanil in patients undergoing gynecology surgery

作　　者：杨帆[1] 高林林[1] 李洋[1] 孟凌新[1] 

机构地区：[1]中国医科大学附属盛京医院麻醉科,沈阳110004

出　　处：《实用药物与临床》2012年第12期794-796,共3页Practical Pharmacy and Clinical Remedies

摘　　要：目的探讨酮咯酸复合曲马多用于妇科手术超前镇痛对术后舒芬太尼PCA效果的影响。方法择期于全麻下行妇科手术患者90例,随机分为3组,每组30例。实验组(T组)静注酮咯酸0.5 mg/kg复合曲马多2 mg/kg,侧管滴入;T1组静脉注入0.5 mg/kg酮咯酸,侧管滴入;对照组(N组)侧管滴入生理盐水5 mL。术毕三组均给予患者自控静脉镇痛泵术后镇痛(PCIA),镇痛药配方为舒芬太尼2μg/kg,稀释至100 mL,首次量为5mL,背景剂量2 mL/h,追加量0.5 mL,锁定时间15 min。记录术后1、4、6、12、24 h内的镇痛评分(VAS)、镇静评分(Ramsay)、患者自控镇痛泵的次数、不良反应及术后镇痛满意度。结果 T组和T1组患者术后1、4 h的VAS评分显著低于对照组(P<0.05),而T组1、4 h的Ramsay镇静评分高于T1组和N组(P<0.05)。T组及T1组术后24 h内PCA按压次数显著低于N组(P<0.05),各组患者在PCA期间不良反应发生率差异无统计学意义(P>0.05)。T组及T1组患者术后镇痛满意度高于N组(P<0.05)。结论酮咯酸复合曲马多用于妇科手术患者的超前镇痛,可明显减少舒芬太尼的用量,提高镇痛镇静质量。Objective To observe the effect of preemptive ketorolac tromethamine combined with tramadol on postoperative analgesia of sufentanil in patients undergoing gynecology surgery.Methods 90 patients undergoing gynecology surgery were randomized into 3 groups：group T,group T1 and group N,30 cases in each group.Group T received ketorolac 0.5 mg/kg combined with tramadol 2 mg/kg,group T1 received the ketorolac 0.5 mg/kg,group N received saline 5 mL at 30 min before the end of the operation.All the patients received PCIA with sufentanil 2 μg/kg at the PCIA rate of 2 mL/h,first dose of 5 mL,bolus dose of 2 mL,and the lock time was 15 min.The visual analogue score（VAS）,Ramsay calm score（1,4,6,12 and 24 h）,adverse reaction and postoperative analgesia degree of satisfaction were recorded.Results The VAS score of group T and T1 were lower than those of group N（P0.05）,Ramsay calm score of group T and T1 were higher than those of group N（P0.05）at 1 h and 4 h after operation.The total PCA demand times in group T and T1 were lower than those of group N in 24 h after operation（P0.05）,and there was no significant difference in the untoward effect among the 3 groups（P0.05）.The satisfaction degree of patients in group T and T1 were higher than that of group N（P0.05）.Conclusion Postoperative analgesia with preemptive ketorolac tromethamine combined with tramadol can reduce the dosage of sufentanil significantly,and it can improve the effect of analgesia.

关 键 词：酮咯酸氨丁三醇 曲马多 舒芬太尼 术后镇痛 超前镇痛 

分 类 号：R614[医药卫生—麻醉学]