曲马多不同方式预注用于腹腔镜胆囊切除术镇痛

Different Ways of Tramadol Injection for Pre-laparoscopic Cholecystectomy Pain

目的通过不同方式静脉滴注曲马多用于腹腔镜胆囊切除术以评价其镇痛作用。方法 2007年8月-2009年8月择期行腹腔镜胆囊切除术患者90例,ASAⅠ或Ⅱ级,随机分成A、B、C、D组,在全身麻醉诱导后和手术结束时两个时间点分别给予曲马多2.5mg/kg或生理盐水,A组曲马多,生理盐水;B组生理盐水,曲马多;C组曲马多;D组生理盐水。分别于手术后2、4、8、24h进行视觉模拟评分法(VAS)评分,了解不良反应的发生情况及镇痛药的使用情况。结果手术后2、4、8、24h,A、B、C组VAS评分低于D组(P<0.05);手术后8h,A、C组明显低于B、D组(P<0.05)。结论曲马多2.5mg/kg预注用于腹腔镜胆囊切除术的超前镇痛是可行而有效的。

Objective To evaluate the analgesic effect of intravenous tramadol in laparoscopic cholecystectomy through different ways. Methods Ninety patients of elective laparoscopic cholecystectomy （ ASA Ⅰ or Ⅱ） from August 2007 to August 2008 were randomly divided into group A,B,C,and D,which were given Tramadol （ 2. 5 mg/kg） or normal saline after the induction of general anesthesia and end of surgery. Group A：first tramadol then normal saline,group B：first saline then tramadol; group C：only given tramadol; group D：only given normal saline,respectively give VAS scores two,four,eight and 24 hours after surgery to understand the occurrence of adverse reactions and the use of analgesic drugs. Results The VAS scores two,four,eight and 24 hours after surgery,the scores of group A,B and C were lower than that of group D （ P〈 0. 05） ,VAS scores eight hours after surgery of group A and C were lower than that of group B and D （ P〈 0. 05）. Conclusions The tramadol （ 2. 5 mg/kg） pre-injection for analgesia of laparoscopic cholecystectomy is feasible and effective analgesia.