双氯芬酸钠联合曲马多对开腹子宫肌瘤术后镇痛效果的观察

Observation on analgesic efficacy of diclofenac sodium combined with tramadol after transabdominal myomectomy

目的观察双氯芬酸钠联合曲马多对开腹子宫肌瘤剔除术后的镇痛效果。方法选取2019年9月至2020年8月,赤道几内亚(简称赤几)巴塔地区医院(简称巴塔医院)择期行开腹子宫肌瘤剔除术患者70例,随机分为研究组和对照组,每组各35例。研究组术后镇痛采取双氯芬酸钠75 mg肌注和曲马多100 mg静滴;对照组为双氯芬酸钠75 mg和安乃近500 mg肌注。用数字评分法(NRS)评估和记录患者术后48 h内静息及运动状态下疼痛强度;记录头晕、恶心和呕吐的例数;记录术毕12 h内采取镇痛补救的例数。结果研究组术后T1时间点的运动状态及T2、T3时间点静息和运动状态NRS评分明显少于对照组相同时间点,差异有统计学意义(P<0.05)。T1时间点静息状态及T4、T5时间点静息和运动状态NRS评分比较,差异无统计学意义(P>0.05)。两组镇痛补救例数比较,差异有统计学意义(P<0.05)。两组镇痛不良反应比较,差异无统计学意义(P>0.05)。结论双氯芬酸钠联合曲马多有效降低开腹子宫肌瘤剔除术后的疼痛强度,镇痛效果优于双氯芬酸钠联合安乃近。

Objective To observe the analgesic efficacy of diclofenac sodium combined with tramadol after transabdominal myomectomy.Methods A total of 70 patients undergoing elective transabdominal open myomectomy admitted to Bata Reginal Hospital(referred to as Bata Hospital)of Equatorial Guinea(referred to as EG)from September 2019 to August 2020 were selected and randomly divided into the study group(n=35)and the control group(n=35).The study group was treated with diclofenac 75 mg by intramuscular injection and tramadol 100 mg by intravenous drip for postoperative analgesia,while the control group was treated with diclofenac 75 mg and analgin 500 mg by intramuscular injection.The pain intensity of patients at rest and motion state with 48 hours after operation was evaluated and recorded by numeric rating scale(NRS).The number of cases of dizziness,nausea and vomiting,as well as the number of patients who took analgesic remedy within 12 hours after the operation were recorded.Results After operation,the NRS scores between the motion state at T1 time point and the rest and motion states at T2 and T3 time points in the study group were significantly lower than those in the control group at the same time point,with statistically significant differences(P<0.05).There were no statistically significant differences in NRS scores between the rest state at T1 time point and the rest and motion states at T4 and T5 time points(P>0.05).There was statistically significant difference in the number of cases of analgesic remedy between the two groups(P<0.05).And there was no statistically significant difference in analgesic adverse reactions between the two groups(P>0.05).Conclusion Diclofenac sodium combined with tramadol can effectively reduce the pain intensity after transabdominal myomectomy,and the analgesic efficacy is superior to diclofenac sodium combined with tramadol.