曲马多自控镇痛在前列腺切除术后的应用

Patient controlled analgesia with tramadol applied after prostate operation

目的观察前列腺术后静脉和硬膜外曲马多患者自控镇痛(PCA)效果。方法90例前列腺切除患者随机分为静脉注射曲马多患者自控镇痛(PCIA)组、经硬膜外曲马多患者自控镇痛(PCEA)组和未使用术后镇痛(对照)组,每组30 例。曲马多负荷量为1 mg/kg。术后定时进行镇静、镇痛评分、24 h曲马多用量、患者满意度、膀胱痉挛次数、膀胱痉挛时间、膀胱冲洗液转清时间及不良反应观察。结果PCIA和PCEA组患者术后视觉模拟评分低于对照组( P <0.05),镇痛满意度好于对照组( P <0.05);PCIA组24 h用药量、按键次数及VAS评分均明显低于PCEA组( P < 0 05),镇静评分、不良反应发生率与PCEA组无显著性差异。结论曲马多用于前列腺切除术后镇痛安全有效,且静脉注射镇痛效果优于硬膜外给药。

ObjectiveTo observe the effect of patient controlled analgesia (PCA) of with tramadol intravenous and epidural injection after prostate operation.Methods90 patients undergoing prostatectomy were randomly divided into intravenous PCA group (PCIA), epidural PCA group (PCEA) and control group (not using easy pain drug), with 30 cases in each group. The loading dose of tramadol was 1 mg/kg. The severity of pain, incidence of nausea and vomiting, total dosage of tramadol used in 24 h ,and patient's satisfaction were assessed.ResultsThe postoperative pain scores of PCIA group were significantly lower than that of PCEA group. Between two groups, there were no significant differences in the overall satisfaction of pain relief, sedation and vomiting.ConclusionPCA with tromadol is safe and effect after prostate operation, and the effect of intravenous PCA is better than that of epidural PCA.