曲马多与布比卡因及罗哌卡因用于小儿术后镇痛的比较

Tromadol Compared with Ropivacaine and Bupicaine for Analgesia After Children Surgery

目的:比较曲马多与布比卡因及罗哌卡因用于小儿硬膜外术后镇痛的效果和副作用。方法:45例ASAⅠ级～Ⅱ级、年龄8岁～11岁硬膜外麻醉患儿随机分成三组,术后硬膜外腔镇痛,A组(n=15)曲马多1mg/kg+0.125%罗哌卡因5ml;B组(n=15)曲马多1mg/kg+0.125%布比卡因5ml;C组(n=15)单纯0.125%罗哌卡因5ml。手术结束前给予镇痛药,观察给药后30分钟的血压(MAP),心率(HR)和氧饱和度(SpO2),并记录疼痛完全缓解,明显缓解时间,效果及副作用。结果:三组给药后,MAP、HR、SpO2无明显变化,疼痛完全缓解时间及维持时间,A组、B组无明显差异,A组、B组明显长于C组;恶心呕吐、尿潴留只发生在B组。结论:曲马多联合低浓度局麻药用于小儿术后硬膜外镇痛安全、有效,罗哌卡因比布比卡因更适合用于小儿术后镇痛。

Objective.To compare the analgesic effects and side effects among tromadol, ropivacaine and bupicaine for postoperative epidural analgesia in children. Methods.Forty five cases underwent epidural analgesia were assigned in group A （n= 15） in which 5ml injection （1mg/kgtromadol＋0. 125% ropivacaine） was administrated through epidural catheter after surgery; group B （n = 15） in which 5ml injection （1mg/kg tromadol＋0. 125% Bupiacaine） was administrated through epidural catheter after surgery; andgroup C （n = 15） in which 0. 125% ropivacaine 5ml was given alone. The HR,MAP and SpO2 were recorded after 30 minutes drug, as well as the pain relives, maintaining time, analgesia efficiency and side effects. Results：There were no significant difference among MAP, HR and SpO2. The complete pain time in group A and B were longer than in group C, and no significant difference between group A and B. Nausea and vomiting only occurred frequently in group B. Conclusions： Tromadol combine with weak concentration local anesthetics was safe and more effective for postoperative epidural analgesia in children, Ropivacaine was more beneficial than bupicaine for postoperative epidual analgesia in children.