小剂量咪唑安定复合曲马多用于老年人术后静脉镇痛的研究

Study of low dose Midazolam combined with Tramadol on postopera tive controlled intravenous analgesia in aged people

目的 研究小剂量咪唑安定复合曲马多在老年人术后静脉镇痛(PCIA)中的临床效果。方法 选择12 0例ASAⅠ～Ⅱ级、上腹部及胸部手术的老年患者,随机分成3组各4 0例。T0 组予曲马多80 0mg ,TM1组予曲马多80 0mg +咪唑安定0 .1mg/kg ,TM2 组予曲马多80 0mg +咪唑安定0 .2mg/kg ,均用生理盐水稀释至10 0mL行PCIA ,记录镇痛后2 ,4 ,8,12 ,2 4 ,4 8h各时间点的疼痛及镇静评分,监测HR、BP、RR、Sp(O2 )并记录不良反应。结果 3组患者心率、血压平稳,未见呼吸抑制,脉搏血氧饱和度均维持在95 %以上。12h内疼痛评分TM1组、TM2 组明显低于T0 组(P <0 .0 5 ) ,镇静评分T0 组最轻,TM1组镇静适当,TM2 组镇静过度。恶心呕吐发生率TM1组、TM2 组显著低于T0 组(P <0 .0 1) ,TM1组与TM2 组组间疼痛评分及并发症方面没有明显差别。结论 小剂量咪唑安定复合曲马多用于老年人术后静脉镇痛效果好,安全性高,不良反应少。

Objective It is to study the clinical effect of low dose Midazolam com bined with Tramadol on postoperative controlled intravenous analgesia (PCIA) in aged people. Methods 120 old patients with ASA Ⅰ～Ⅱ degree sched uled for upper a bdominal and thoracic surgery were randomly divided into three groups. Every one had 40 cases. Group T 0 was given Tramadol 800 mg, group TM 1 was given Trama dol 800 mg + Midazolam 0.1 mg/kg, group TM 2 was given Tramadol 800 mg+ Midazolam 0 .2 mg/kg. All the drugs were diluted to 100 mL with normal sodium to do PCIA. Pain and mitigation scores and untoward reaction were recorded, HR, BP, RR and Sp (O 2) were measured at 2, 4, 8, 12, 24 and 48 h after PCIA being done. Result s HR, BP kept unchanged and Sp(O 2) exceeded 95%, no respiratory depression was fou nd in the three groups. The pain scores in group TM 1 and group TM 2 were obviously less than that in group T 0 (P<0.05). The sedative score in group T 0 was less , that i n group TM 1 was moderate, and that in group TM 2 was over. The incidences of naus ea and emesis in group TM 1 and group TM 2 were significantly lowered than tha t in group T 0 (P<0.01). There was no significant difference in pain scores and compl ication between group TM 1 and group TM 2. Conclusion Low dose M idazolam combined with Tramadol on postoperative controlled intravenous analgesia in aged people i s safe and effective with less untoward reaction.