曲马多用于颞部入路开颅术后镇痛的临床观察

Clinical Observation of Postoperative Analgesia with Tramadol after Temporal Craniotomy Approach

目的观察曲马多单独用于颞部入路开颅术后静脉自控镇痛(PCIA)的效果。方法选择120例择期颞部入路开颅手术患者,随机分为曲马多组(T组)、吗啡组(M组)各60例,术后行静脉自控镇痛(PCIA)。记录术后4、16、24、48h静息/运动状态的视觉模拟疼痛评分(VAS),镇痛泵按压次数,不良反应,补救用药。结果 VAS(静息)评分在术后4、16h,T组明显高于M组;VAS(运动)评分在术后4、16、48h,T组明显高于M组(P<0.05)。PCA次数T组明显高于M组(P<0.05)。补救用药,各种不良反应及呕吐发生率(T组51.7%,M组50.0%)差异均无统计学意义。结论曲马多用于神经外科开颅术后镇痛安全可靠,不增加术后恶心呕吐发生率。

Objective To observe the efficacy tramadol in patient-controlled intravenous analgesia （PCIA） after temporal craniotomy approach. Methods One hundred and twenty patients undergoing temporal craniotomy surgery were equally randomized into two groups （n=60）： Tramadol 1000rag（T） group, Morphine 30 mg （M） group and managed with patient-controlled intravenous analgesia. Visual analogue scale （resting/movement）, analgesia pressing times, adverse reactions and drug remedy were evaluated at 4, 16, 24 and 48 h after surgery. Results VAS（resting） was higher in T group than in M group at 4,16 h and VAS（movement） was higher in T group than in M group at 4, 16, 48 h （P〈0.05）. Analgesia pressing times were higher in T group than in M group （P〈0.05）. There were no significant difference between two groups with adverse reactions and drug remedy.The incidence of nausea and vomiting is 51.7% in T group and 50.0% in M group. Conclusion Tramadol can provide safe and reliable postoperative analgesia after craniotomy, does not increase the incidence of postoperative nausea and vomiting.