曲马多用于术后静脉自控镇痛的效果评价  

Evaluation of tramadol in postoperative patient-controlled intravenious analgesia

作　　者：张毅[1] 张咸伟[1] 潘黎[1] 田玉科[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院麻醉学教研室,武汉市430030

出　　处：《临床麻醉学杂志》2003年第5期265-267,共3页Journal of Clinical Anesthesiology

摘　　要：目的　将曲马多与传统的阿片类药物进行对比 ,对其镇痛效果进行评估。方法　 90例ASAⅠ～Ⅱ级的中下腹手术病人 ,随机分为三组 ,每组 30例 ,曲马多组 (T组 ) :负荷剂量 1 5mg/kg ,按压剂量 10mg ,背景输注量 10mg/h ,间隔时间 5min ;芬太尼组 (F组 ) :负荷剂量 1μg/kg ,按压剂量 10 μg ,背景输注量 10 μg/h ,间隔时间 5min ;吗啡组 (M组 ) :负荷剂量 0 15mg/kg ,按压剂量0 5mg ,背景输注量 1mg/h ,间隔时间 5min。观测患者 2 4h内心率、血压、呼吸频率、脉搏血氧饱和度、VAS、镇静评分、PrinceHenry评分 (PHS)以及不良反应的发生率 ,并记录患者 2 4h内用药量。结果　镇静评分 (SS)、VAS、PHS三组病人无显著性差异 ;恶心呕吐的发生率T、M组 >F组 (P <0 0 5 ) ;排气时间延长发生率F、M组 >T组 (P <0 0 5 )。结论　曲马多能够获得与吗啡、芬太尼相同的满意的镇痛效果 ,并且降低了术后排气时间延长的发生率 ,但恶心的发生率高于芬太尼组。Objective To compare the effect and side effect of tramadol with traditional opioids used for patient controlled intravenous analgesia(PCIA) Methods ASA Ⅰ Ⅱ 90 patients (age 20 60 year) undergoing mid lower abdominal operations were blindly randomized into three groups. Group tramadol (group T, n= 30) was given a loding dose 1 5mg/kg, PCA bolus 10mg, background 10mg/h, lockout time 5min; group fentanyl(group F, n= 30),loding dose 1μg/kg, PCA bolus 10μg, background 10μg/h, lockout time 5min;group morphine(group M, n= 30),loding dose 0 15mg/kg, PCA bolus 0 5mg, background 1mg/h, lockout time 5min.Heart rate,blood pressure, respiratory rate,pulse oxygen saturation, VAS,sedation score(SS),Prince Henry Score(PHS) of the patients as well as side effects were observed Total consumption of analgesics within 24 hours were also recorded Results SS,VAS and PHS showed no difference between three groups The rates of postoperative nausea and vomiting(PONV) of group T and group M were higher than those of group F( P< 0 05); The rate of delayed exsufflation in group F and group M were higher than that of group T( P< 0 05) Conclusion When used in postoperative PCIA, tramadol can provide the same and satisfied effect as morphine or fentanyl, with a lower frequency of delayed exsufflation However, the rate of PONV in patients of tramadol PCIA is higher than that in patients of fentanyl PCIA

关 键 词：曲马多 术后疼痛 病人自控镇痛 静脉注射 不良反应 气管插管 静吸复合麻醉 

分 类 号：R614[医药卫生—麻醉学]