N_2O吸入与口服曲马多缓解光动力治疗尖锐湿疣术中疼痛的疗效观察  

Observation of Nitrous Oxide and Single-dose Tramadol in Condyloma Acuminatum Photodynamic Treatment

作　　者：戴红[1] 陈金波[1] 黄茜[1] 任敏[1] 叶静[1] 

机构地区：[1]武汉市第一医院皮肤科,湖北武汉430022

出　　处：《中国皮肤性病学杂志》2016年第3期278-280,288,共4页The Chinese Journal of Dermatovenereology

摘　　要：目的观察N_2O吸入与口服曲马多缓释片在光动力治疗尖锐湿疣术中的镇痛效果。方法将接受光动力(PDT)治疗的尖锐湿疣患者以数字评分法(NRS)对疼痛进行评分,观察并记录PDT照光过程中1min,5min,10min,15min,20min疼痛评分及照光结束后3h,6h,24h,48h及72h疼痛评分。将患者随机分为N_2O组及曲马多组,在第2次光动力治疗过程中分别给予N_2O镇痛及曲马多镇痛:其中N_2O组吸入低浓度笑氧混合气;曲马多组照光前2h口服盐酸曲马多缓释片。结果在照光过程中,N_2O组与曲马多组均具有良好的镇痛效果,与患者的疼痛基础值比较,差异均有统计学意义(P均<0.05),N_2O组优于曲马多组(P<0.05)。照光结束后两组患者疼痛均缓解,术后24h内曲马多组疼痛平均值明显低于N_2O组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05),均未发生严重不良事件。N_2O组患者吸入N_2O前后HR,BP,SpO_2比较,差异无统计学意义(P>0.05)。结论对于光动力治疗过程中疼痛评分NRS>6分的患者,应用N_2O吸入镇痛能更有效的缓解治疗过程中的疼痛,而口服曲马多镇痛则可持续更长时间。Objective To observe the analgesic effect of Nitrous oxide and single-dose tramadol in Photodynamic treatment of condyloma acuminatum. Methods Numeric rating scale（ NRS） were used to assess the pain score of condyloma acuminatum patients treated with photodynamic therpy（ PDT）. The pain scores were observed and recorded 1,5,10,15 and 20 minutes during the irradiation and 3,6,24,48 and 72 hours after the irradiation. Random allocation was taken to these patients as the nitrous oxide group and the tramadol group,receiving nitrous oxide analgesia or tramadol analgesia during the following photodynamic therpy,respectively. The nitrous oxide group took inhalation of low-concentration of mixed oxygen and nitrous oxide. The tramadol group took tramadol hydrochloride sustained-release tablets 2 hours before every irradiation. Results The analgesia effects of the nitrous oxide and the tramadol are both remarkable. There were significant difference between the pain score to the baseline pain score（ P 〈0. 05）. The nitrous oxide group performed better than the tramadol group in analgesia effect（ P 〈0. 05）. The pain of both group were eased after irradiation. Tramadol group average pain score was significantly lower than nitrous group during24 hours after the operation（ P 〈0. 05） There was no statistical significant difference in incidence of adverse reactions between the two group（ P 〉0. 05）. Conclusion The analgesia effect of the low-concentration of mixed oxygen and nitrous oxide is better than oral administration of tramadol,while the analgesia effect of the latter last longer.

关 键 词：光动力疗法 尖锐湿疣 N_2O 口服曲马多 镇痛 

分 类 号：R752.5[医药卫生—皮肤病学与性病学]