曲马多PCIA用于口腔颌面部手术后镇痛的临床研究  

A clinical study on application of tramal in patient controlled intravenous analgesia in maxillofacial postoperative analgesia

作　　者：张青[1] 罗玉琳[1] 郁葱[1] 饶静玲[1] 

机构地区：[1]重庆医科大学附属口腔医院麻醉科,400015

出　　处：《重庆医学》2003年第11期1513-1514,共2页Chongqing medicine

摘　　要：目的　探讨自控静脉注射式镇痛泵在口腔颌面部手术病人使用中常见的问题。方法　 2 0 0 2年 3～ 11月 ,本科全麻及局麻病人 5 0例采用自控静脉注射式镇痛泵 ,5 0例作为对照 ;PCA流量 :0 5ml/min。药物组合 :曲马多 5 0 0～ 80 0mg +氟哌利多5mg ,按 2ml/h的速率静脉持续注入。使用时机 :手术结束后 5～ 10min ,选择上肢静脉 ,用留置针穿刺 ,首先静推负荷剂量曲马多5 0～ 10 0mg+蒽丹西酮 4mg后 ,再衔接一次性微量止痛泵。结果　所有病例镇痛情况良好 ,血压、脉搏、呼吸、血氧饱和度等生命体征平稳 ;有 6 0 % (3例 )术后第 2天出现头晕、呕吐等症状 ,给予静注蒽丹西酮、增加输液量、口服眩晕停 ,症状基本缓解 ,只有 1例用药后症状缓解不明显 ,停用镇痛泵后症状逐渐缓解 ,无并发症发生。结论　自控静脉注射式镇痛泵在口腔颌面部手术中的应用是安全的 ,效果肯定。Objective To study the clinical value and method of application of patient controlled intravenous analgesia(PCIA)in maxillofacial postoperative analgesia.Methods In a randomized study,100 adult patients undergoing elective maxillofacial opterations were assigned into two groups.In PCIA group (test group),50 patients were administered by infusing tramal 500-800mg and droperidol 5mg diluted to 100ml of loading-congtinuous-bolus mode,the continuous dose was 2ml/h.Group Ⅱ(control group)50 patients only were given placebo.The Tramal loading dose was 50-100mg plus ondansetron 4mg before using PCIA.Results In group I,the life signs including BP,HR,RR,SpO 2 of all patients were normal;but 3 patients had nausea,vomitting.Conclusion Tramal using in PCIA is safe and PCIA is an effective method for maxillofacial postoperative analgesia.

关 键 词：口腔颌面部手术 曲马多 术后镇痛 临床治疗 PCIA 

分 类 号：R782.2[医药卫生—口腔医学]