舒芬太尼联合曲马多用于全髋关节置换术后镇痛的研究  

Clinical observation of sufentani and tramadol for postoperative analgesia after total joint replacement

作　　者：夏明[1] 李慧[2] 姬宁宁 童建华[1] 段满林[1] 徐建国[1] 张咏梅[3] 

机构地区：[1]南京军区南京总医院麻醉科,江苏南京210002 [2]临沂市人民医院麻醉科,山东临沂276000 [3]徐州医科大学江苏省麻醉学重点实验室,江苏徐州221004

出　　处：《徐州医学院学报》2016年第9期572-574,共3页Acta Academiae Medicinae Xuzhou

摘　　要：目的探讨曲马多联合舒芬太尼用于髋关节术后镇痛的合理配伍。方法择期行全髋关节置换术患者150例，随机分成5组：单独曲马多组（T组）、舒芬太尼组（S组）、高剂量曲马多和低剂量舒芬太尼组（TSl）、曲马多和舒芬太尼平衡配伍组（TS2组）、低剂量曲马多和高剂量舒芬太尼组（TS3组）。各组于手术结束前30rain给予相应负荷剂量后行不同配伍的药物进行术后静脉镇痛。分别记录患者术后2、4、8、12、24、48h静息时和90。翻身活动时的VAS评分、Ramsay镇静评分、副作用等。结果TS2组、Ts3组和S组在术后各时间点安静和90。翻身活动时的VAS评分均显著低于T组（P〈0．05）。S组、TS2组和TS3组术后各时间点的Ramsay镇静评分均高于T组（P〈0．05）。S组和TS3组的Ramsay镇静评分均高于TS2组（P〈0．05）。S组和TS3组的Ramsay镇静评分无统计学意义。S组恶心呕吐等不良反应较严重。结论舒芬太尼和曲马多平衡配伍组的效果最佳，副作用最小。Objective To investigate the effects of tramadol combined with sufentani on postoperative analgesia after total joint replacement. Methods A total of 150 patients who were scheduled to undergo total joint replacement were randomly divided into five groups （n = 30） ： a tramadol group （Group T）, a sufentani group （Group S）, a small -dose sufentani plus large - dose tramadol group （ Croup TS1 ） , a balanced - dose of tramadol and sufentani group （ Group TS2 ） and a large - dose sufentani plus small - dose tramadol group （ Group TS3 ）. Each group received intravenous anal- gesia using corresponding doses of medications 30 rain before the end of surgery. Their VAS scores at resting and 90 de- gree turnover 2,4, 8, 12, 24, 36,48 hour after surgery were recorded. Ramsay sedation scores and side effects were al- so measured. Results The VAS scores in Groups S, TS2 and TS3 at resting and 90 degree turnover at each time point after surgery were significantly lower than that in Group T （ P 〈 0.05 ）. The Ramsay sedation scores in Group S, TS2, and TS3 at each time point after surgery were significantly higher than that in Group T （ P 〈 0.05 ）. The Ramsay sedation scores were higher in Groups S and TS3 than that of Group TS2 （ P 〈 0.05 ） , in which no statistical difference was seen between Groups S and TS3. Group S showed more severe adverse reactions, such as nausea and vomiting. Conchlsiolls The analgesic effects of the balanced - dose tramadol and sufentani group is best, with the least side effects.

关 键 词：曲马多 舒芬太尼 术后镇痛 全髋关节置换 

分 类 号：R614[医药卫生—麻醉学]