曲马多复合小剂量芬太尼术后静脉镇痛的临床观察

Clinical Observation on Postoperative Patient-controlled Intravenous Analgesia by Tramadol Combined with Small-dose Fentanyl

目的观察曲马多配伍其他静脉用药在术后镇痛镇静中的作用。方法随机将 12 0例择期腹部手术患者分成三组 ,A组用药为芬太尼 +氟哌啶 ;B组为曲马多 +氟哌啶 ;C组为曲马多 +小剂量芬太尼 +氟哌啶 ,观察在 4 8h内三组的镇痛、镇静及副作用。结果A组、C组镇痛满意 ,二组间差异无显著性 (P >0 .0 5 ) ;B组最差 ,与A组、C组差异有显著性 (P <0 .0 0 1,P <0 .0 5 ) ;C组镇静适当 ,A组镇静过度 ,B组最轻 ,组间比较差异显著 (P <0 .0 0 1) ;副作用恶心、呕吐 ,B显著高于A组、C组 ,组间比较差异显著 (P <0 .0 0 1)。结论曲马多加小剂量芬太尼可安全有效地运用于术后静脉镇痛 ,并可按需要镇静。

ObjectivesTo observe the effects of tramadol combined with other intravenous drugs in postoperative patient controlled intravenous analgesia (PCIA).MethodsOne hundred and twenty patients scheduled for abdominal operations were randomly divided into three groups: Group A fentanyl plus droperidol was administered; Group B tramadol plus droperidol; Group C tramadol and small dose fentanyl plus droperidol. The analgesia, sedation and side effects of three groups within 48 hours were recorded , respectively.ResultsThe analgesia in group A and group C was satisfactory, without significant difference between both (P> 0.05 );whereas the result in group B was worst, showing very significant differences as compared with group A and group C(P< 0.001 and 0.05 ). The sedation in group C was moderate, but over sedation and least effect were seen in group A and group B respectively; comparison among 3 groups revealed distinctly significant differences (P< 0.001 ) .Incidence of nausea and vomiting in group B was obviously higher than that in group A or group C (P< 0.001 ).Conclusion PCIA with tramadol plus small dose fentanyl is safe and feasible. Sedation may be effected according to requirement.