乳腺癌根治术后曲马多PCIA与吗啡PCEA临床对比研究

Clinical Study of the Patient Controlled Analgesia with Tramadol Intravenous and Morphine Epidural in Postoperative Radical Mastectomy of Breast Cancer

目的 观察比较乳腺癌根治术后曲马多PCIA与吗啡PCEA临床镇痛效果及副作用。方法 乳腺癌根治术后病人 12 0例。随机分两组 :T组 (PCIA组 ) ,M组 (PCEA组 )。PCA设备 :2ml/h持续输注 ,单次PCA剂量 0 .5ml,锁定时间 15min。术后 6 ,12 ,2 4 ,4 8小时观察病人药物用量、镇静镇痛评分 ,满意水平及副作用。结果 T组 4 8小时Tramadol用量 (90 8.2± 5 9.7)mg ,按键次数 (6±1.5 )次 ;M组Mor phine(4 .8± 0 )mg ,按键次数 (0 )次。镇痛效果 :VAS及SS评分无显著性差异 ,优良率 >98%。副作用 :T组病人恶心、呕吐发生率明显低于M组 (P <0 .0 1)。结论 曲马多PCIA与吗啡PCEA镇痛效果确切 。

Objective To compare the pain relief efficacy and complication of tramadol intravenous PCA(PCIA) and morphine epidural PCA(PCEA).Methods 120 patients of breast cancer were divided randomly into two groups:Group T(n=60) PCIA Group M (n=60) PCEA. Administrated PCA with Automen 2300 pung of Koera, PCA setting:bolus dose (0.5)ml, background infusion 2ml/h, lockout time of 15 min. The following varable were recorded at 6,12,24 and 48 hours after operation:dosage of drugs,VAS, SS, patient satisfaction and complication. Results Trmadol ((908.2)±(59.7))mg, press key ((6.0)±(1.5)); morphine ((4.8)±0)mg , press key (0). There was no significant difference between PCIA and PCEA in VAS, SS and patient satisfaction rate (>98%). The rate of nause and vomiting in group T was significantly lower than that of group M (P>(0.01)),group M tickle 25%, nause and vomiting 28%. There was no significant difference between two groups in respiratory and circulation(P>(0.05)). Conclusion It is suggested that PCIA is better than PCEA, which might be lower in the rate of complications with the patient controlled analgesia.