口服盐酸曲马多在中青年鼻内镜手术后及换药中镇痛效果的临床观察

To observe postoperative analgesia and preemptive analgesia of Tramadol hydrochloride sustainedrelease tablets for nasal endoscopic operation

目的:探讨口服盐酸曲马多在中青年鼻内镜手术后及换药中的镇痛效果。方法:对鼻中隔偏曲、慢性鼻-鼻窦炎(不伴鼻息肉)、慢性鼻-鼻窦炎(伴鼻息肉)或真菌性鼻窦炎4种疾病的中青年患者94例(实验组)采取鼻内镜术后前3d和换药期间多时段口服盐酸曲马多的方法,应用视觉模拟评分法观察鼻内镜术后患者疼痛程度并进行评分;观察其他不良反应,如失眠、烦燥不安、痰多呛咳、进食多少和进食种类等;观察换药时患者状况,如精神是否紧张或恐惧、出血量、头昏或晕厥、有无休克等。同时随机选择相同患者94例作为对照组,对照组术后不给予曲马多口服,其余治疗同实验组。结果:实验组患者术后当晚疼痛明显减轻,夜间入睡较快,第2天精神好,进食多,术后2d疼痛评分显著低于对照组;换药时无恐惧感,疼痛轻,换药进程缩短,出血明显减少,无晕厥和休克等严重不良反应发生。结论:口服盐酸曲马多对中青年鼻内镜术后及换药过程有明显镇痛效果,并大大减低患者术后各种反应,加快康复。视觉模拟评分法是评估患者术后疼痛的一种简便、易学、便于开展的主观评估方法。

Objective：To observe postoperative analgesia and preemptive analgesia of Tramadol hydrochloride sustainedrelease tablets for nasal endoscopic operation.Method：A total of 188 patients undergoing nasal endoscopic operation were randomized into the experimental group and control group,with 94 patients in each group.Each patient in experimental group was gaved one Tramadol hydrochloride sustainedrelease tablets at 12 h,24 h,48 h postoperation and before the cleaning up procession respectively,the control group was not administrated.VAS scores were observed at 12,24 and 48 hours after operation.The discomfort reaction during postoperation and cleaning up procession such as insomnia,impatien,nervous,frightening,syncope and shock were also obeserved and recorded.Result：Visuala analogne scale scores of the experimental groups after 12,24 hours and 48 h were significantly lower than the control group.The discomfort reaction appeared more frequently in control group.Conclusion：Tramadol hydrochloride sustainedrelease tablets effectively relieves postoperative pain of nasal endoscopic operation.It can also decrease the discomfort reaction during postoperation and cleaning up procession and facilitate the recovering of patients.