小儿术后曲马多自控镇痛的临床研究

The Clinical Study of Using Patient Controlled Analgesia Tramadol for Pediatric Post-operation

目的：观察小儿外科患者术后用曲马多自控镇痛的效果及副作用。方法：120名患儿，手术近结束时给予负荷剂量曲马多1．3～2．0mg／kg，手术结束即刻连接自控镇痛泵按曲马多0．20～0．31mg／（kg·h）PCA给药。随访观察：①术后疼痛强度评分；②副作用；③术后额外补充镇痛药剂量及次数。结果：①镇痛24h VAS评分为0．21±2．12，镇痛48h VAS评分为1．26±1．01。3例需额外补充镇痛药。②副作用：24h内有头晕者为32例（26．67％），8h有头迷者为21例（17．5％）。6例排尿困难。7例有下肢麻软感觉。8例皮肤瘙痒。排气时间为（41．2±12．4）h。无呼吸抑制病例。结论：曲马多用于小儿自控镇痛具有安全有效、不良反应少的优点，可供临床推广。

Objective： To observe the delf - control analgesic effect and side effect of Tramadol after pediatric surgery： Method： 120 children was received automatic analgesic pump, using Tramadol 0.20～0.31 mg/（kg·h） through PCA. Analgesic effect score, side effect and the dosage as well as frequency of additional pain - killer was analysis. Result： 24h VAS score was 21±2.12 and 48h VAS score was 1.26±1.01, respectively. There were 3 cases need additional pain - killer. Conclusion： Tramadol is a very efficient and low adverse effect reagent, which can be used in clinic department.