曲马多与吗啡用于妇科开腹手术后病人自控镇痛的比较

Patient-controlled Analgesia with Tramadol vs Morphine in Patients Undergoing Abdominal Gynecological Surgery

目的：比较曲马多与吗啡用于妇科开腹手术后病人自控镇痛（ｐａｔｉｅｎｔ－ｃｏｎｔｒｏｌｌｅｄ ａｎａｌｇｅｓｉａ，ＰＣＡ）的镇痛效应及药物不良作用。方法：选择５９例择期妇科开腹手术病人，术后随机将病人分为Ｔ组和Ｍ组，接受病要自镇痛治疗。Ｔ组使用曲马多（每次１２．５ｍｇ，总量４００ｍｇ·２４ｈ～（－１），Ｍ组使用吗啡（每次１．２５ｍｇ，总量４０ ｍｇ·２４ｈ～９－１）。结果：曲马多与吗啡组的疼痛缓解评分总和（ＴＯＴＰＡＲ）分别为１５．９±４．４和１６．４±３．５（Ｐ＞０．０５），疼痛程度差值总和（ＳＰＩＤ）分别为９．２±４．７和９．０±２．０（Ｐ＞０．０５）。曲马多组的恶心及呕吐发生率低于吗啡组，分别为１６．７％和２６．７％。结论：曲马多用于妇科开腹手术后病人自控镇痛的效应与吗啡接近，可引起轻度的恶心及呕吐。

OBJECTIVE: To value the analgesic effect and drug adverse reaction of PCA with tramadol compared with morphine. Methods 59 patients,scheduled for elective hysterectomy or hysteromyomectomy, were randomly divided into Group T and Group M. Two drugs administered IV via a patient-controlled analgesia for up to 24 h postoperative. RESULTS: Efficacy was assessed by comparing total pain relief (TOTPAR) and sum of pain intensity difference (SPID) over 24h. Statistically significant equivalence of tramadol and morphine was shown by TOTPAR values15.9±4.4 and 16.4±3.5 by SPID values 9.2±2.7 and 9.0±2.0 respectively ( P>O.05). Tramadol caused fewer adverse events than morphine (16.7% and 26.7% of patients,respectively. CONCLUSION: The study suggests that tramadaol provides an alternative to morphine for the treatment of postoperative pain.