盐酸丙帕他莫与曲马多用于人工流产术镇痛的双盲对照研究

A Controlled Double-blind Study on the Analgesic Effect of Propacetamol Hydrochloride and Tramadol in Induced Abortion

目的:评价盐酸丙帕他莫与曲马多用于人工流产术镇痛的效果。方法:选择ASAⅠ级,孕(6～12)周,自愿接受无痛人工流产的患者80例,随机分P组和T组两组,每组40例,P组术前30min静注生理盐水2ml后静脉滴注丙帕他莫2g溶于100ml生理盐水;T组术前30min静注曲马多100mg(2ml)后静脉滴注100ml生理盐水。两组手术消毒时开始靶控输注(TCI)异丙酚,术毕停药。按随机双盲目对比研究,记录术前和术中平均动脉压(MBP)、心率(HR)和血氧饱和度(SpO_2)变化,评价注射痛、术中麻醉镇痛效果、术后10min、30min、1h、2h、4h、6h镇痛(采用VAS评分法)评分和不良反应。结果:两组术中MBP较术前明显下降(P<0.01),HR、SpO_2无明显变化;两组注射痛和术中镇痛效果差异无显著性(P>0.05);P组术后10min、30min、1h、2h的VAS值小于T组(P<0.01);T组术后30min内恶心、呕吐及头晕的发生率高于P组(P<0.05)。结论:丙帕他莫与曲马多可安全有效的用于人工流产术,丙帕他莫术后镇痛效果强于曲马多,且不良反应少。

Objective：To evaluate the effect of abortion analgesia by using propacetamol hydrochloride and tramadol. Methods：Selecting the ASA I grade,6 to 12 weeks of pregnancy,80 patients who were voluntarily accepted abortion were randomly divided into two groups which were Group P and Group T,and 40 patients were in each group.Group P were injected 2ml of NS and 2g of propacetamol which was dissolved in 100ml of NS 30 minutes before the surgery while Group P were injected 100mg of tramadol（2ml） and 100ml of NS at the same time.Two groups were target-controlled injected propofol,and withdrawal the drugs after the operation.After that,recorded the changes of mean arterial blood pressure （MBP）,heart rate （HR）,oxygen saturation （SpO2） and the analgesic effect of intraoperative anesthesia and postoperative 10min,30min, l h,2h,4h,6h analgesia （VAS） scores and adverse reactions.Results：MBP decreased significantly compared with the preoperative（P〈0.01）,and the HR and SpO2 were no significant changes;The injection pain and the difference of the analgesic effect were no statistically significant（P〉0.05）;The VAS value of Group P were less than Group T after 10min,30min, lh,2h（P〈0.01）;The nausea,vomiting and dizziness of Group T were higher than Group P after 30min （P〈0.05）.Conclusion：Propacetamol and tramadol are safe and effective for abortion,and the analgesic effect of propacetamol is stronger than tramadol and it also has few adverse reactions.