加巴喷丁对腹腔镜子宫切除术患者曲马多术后镇痛的影响  

作　　者：程远[1] 陈淑萍[1] 郑洁萍[1] 胡方[1] 李庆华[1] 王丽华[1] 

机构地区：[1]杭州市第一人民医院,310006

出　　处：《浙江临床医学》2014年第3期358-359,共2页Zhejiang Clinical Medical Journal

基　　金：杭州市医药卫生科技计划（20098004）

摘　　要：目的：评价术前应用加巴喷丁，对曲马多术后镇痛效果及术后镇痛副反应的影响。方法40例ASA I^II级行择期腹腔镜子宫切除术患者随机分为两组，观察组术前服用加巴喷丁600mg，术后采用曲马多PCA；对照组：术前服用安慰剂，术后采用曲马多PCA。使用视觉模拟量表（VAS）在手术后1、3、6、12、24h时间点评价患者的疼痛情况，采用Ramsay镇静评分评价患者的镇静情况，进行记录，并记录上述各时间点的血压、心率。记录各患者手术后24h内PCA按压次数。记录手术后不良反应：恶心、呕吐、眩晕、呼吸抑制的发生情况。结果两组患者VAS评分无显著差异，观察组与对照组比较，PCA按压次数较少。在Ramsay镇静评分上，两组无显著差异。观察组与对照组相比，恶心、呕吐的发生率较低，两组患者眩晕、呼吸抑制等副反应的发生率相似。结论在腹腔镜子宫切除手术前口服600mg加巴喷丁，可增强曲马多的术后镇痛效果，并降低恶心、呕吐的发生率，且无其他明显的副作用。Objective To evaluate the effects of oral gabapentin on postoperative analgesia with tramadol in laparoscopic hysterectomy. Methods Forty ASA I and II patients were randomly divided into two groups：test group：assigned to receive 600 mg gabapentin before the operation,postoperative analgesia with tramadol;control group：assigned to receive placebo before the operation, postoperative analgesia with tramadol. Patients＇ pain scores were recorded with a visual analogue scale and the Ramsay sedation scale was used to record the sedation score 1,3,6,12,24 hours after the operation,HR and MAP were recorded at the same time points. The occurrence of side effects including nausea,vomiting,dizziness and respiratory depression were recorded. Results The postoperative analgesic effect in each group is good. The times of self-compression in groupⅠwas significantly lower than those in groupⅡ,the times of self-compression in groupⅢwere significantly lower than those in groupⅣ. Sedation scores of groupⅣwas significantly higher than those in other groups on the 1,3,6,12 hour time points. The incidence of nausea and vomiting in groupⅡwere significantly lower than those in groupⅠ, and the same things in groupⅣwere significantly lower than those in other groups. The other postoperative side effects such as dizziness and respiratory depression were similar in each group. Conclusion Premedication with 600 mg gabapentin improves postoperative analgesia and has no significantly side effect on patients with laparoscopic hysterectomy.

关 键 词：加巴喷丁 术后镇痛 曲马多 腹腔镜子宫切除术 

分 类 号：R473.71[医药卫生—护理学]