曲马多与曲马多联合雷莫司琼应用于腹腔镜子宫肌瘤剔除术镇痛效果的比较

Comparison of analgesic effect of tramadol and tramadol combined with ramosetron used in laparoscopic myomectomy

目的观察曲马多与曲马多联合雷莫司琼应用于腹腔镜子宫肌瘤剔除术镇痛效果。方法随机选择择期妇科腹腔镜子宫肌瘤剔除术手术患者80例,随机分为曲马多组(T组)与曲马多雷莫司琼联合组(TR组)。两组患者均接受静吸复合全身麻醉,T组患者仅给予曲马多2 mg/kg,TR组曲马多2 mg/kg,雷莫司琼0.3 mg。记录两组患者各时段镇痛评分及恶心呕吐等不良反应发生率。结果 T组与TR组对比,视觉模拟(VAS)评分在拔除气管导管即时、30min、1 h及4 h各时点均无统计学差异(P>0.05)。两组的恶心发生例数分别为30例,20例,呕吐的发生例数为18例,8例。TR组的恶心、呕吐发生率明显低于T组(P<0.05)。结论腹腔镜子宫肌瘤剔除术围术期使用雷莫司琼与曲马多联合应用与单独使用曲马多比较镇痛效果没有显著差异,雷莫司琼可降低曲马多引起的术后恶心呕吐的发生率。

Objective In order to compare the analgesic effects of tramadol and tramadol combined with ramosetron used in laparoscopic myomectomy. Methods Eighty patients undergoing gynecologic laparoscopic myomectomy were randomly allocated to one of two groups ： T （ tram-adol ）group （n = 40） and TR （tramadol conbined with ramosetron） group （n = 40）. All patients received general anesthesia inhalation, and pa-tients in group T received tramadol 2 mg/kg, while the patients in group TR received tramadol 2 mg/kg and Ramosetron 0. 3 mg. Pain score （VAS） and the incidence of nausea and vomiting were recorded at the time of tracheal extubation. Results There were no significant difference in pain scores between group T and group TR at each point （ P 〉 0. 0 5） . The number of nausea in both groups was 30 cases and 20 cases, respectively, Vomiting 18 cases and 8 cases. The incidence of nausea and vomiting of group T was significantly lower than that of group TR （ P 〈0. 05） . Conclusion Ramosetron does not reduce the analgesic efficacy of tramadol. And ramosetron reduces the incidence of postoperative nausea and vomiting caused by tramadol.