曲马多和芬太尼用于鼻内镜术后病人自控镇痛

The effect of tramadol and fentanyl for patient-controlled analgesia after functional endoscopic sinus surgery

目的比较鼻内镜手术后使用曲马多或芬太尼进行自控镇痛的镇痛效果及不良反应。方法手术患者88例,随机分为曲马多组42例和芬太尼组46例。两组均全麻下行鼻内镜手术。术毕苏醒后送麻醉术后恢复室(PACU),使用曲马多或芬太尼进行自控镇痛(PCA)。术后48h分时点观察病人的一般情况,疼痛、头晕、恶心呕吐、食欲及睡眠等指标。结果术后次日晨(8Am)和术后48h,曲马多组的视觉模拟评分(VAS)明显低于芬太尼组(P<0.01);术后次日晨(8Am)、术后24h和48h曲马多组病人的按压次数明显少于芬太尼组;曲马多组术后48h静脉镇痛使用的总药量明显少于芬太尼组(P<0.01),头晕的发生率高于芬太尼组(P<0.05)。结论鼻内镜手术后镇痛使用PCA,曲马多的效果优于芬太尼。

Objective To compare the analgesic and side effects of tramadol and fentanyl after functional endoscopic sinus surgery （FESS）. Methods 88 adult patients undergoing selective FESS under general anesthesia were divided into two groups and either of them received tramadol or fentanyl for patient- controlled analgesia （PCA）. Vital signs, VAS, Ramsay sedation, dizziness, nausea, vomiting, appetite and sleep etc were observed after the operation for two days. Results VAS in tramadol group was significant lower than that of fentanyl group （ P 〈 0.01 ） at next morning and 48 h after the operation. The number of pressing in tramadol group was fewer than that of fentanyl group at next morning, 24 h and 48 h after the operation. So the total analgesic consumption in fentanyl group was obviously higher than that of tramadol group （ P 〈 0.01 ）. The incidence of dizziness in tramadol group is 64.29% and it is higher than that （32.61% ） of fentanyl group （ P 〈 0.05 ）. Conclusion After the FESS, the effect of PCA with tramadol is better than that with fentanyl.