赖氨比林复合曲马多对下肢骨关节疾病患者的镇痛作用

Analgesic effect of tramadol plus lysine acetyl salicylate in patients with joint disease of lower limb

目的:观察赖氨比林(LAS)复合曲马多术后镇痛效果及不良反应的发生率。方法:30例择期下肢手术患者,随机抽签法分为A组(曲马多)与B组(赖氨比林+曲马多)组,每组15例。两组均采用腰麻联合硬膜外(L2～3间隙)+术后经静脉患者自控镇痛(PCA)。A组手术结束时给予2.5mg/kg曲马多预给量;B组则给予1.25mg/kg曲马多+12.5mg/kg赖氨比林。每隔6h记录1次直至48h,患者感觉疼痛时可用药,并记录给药时间、两组用药量以及不良反应的发生。按视觉模拟评分(VisualAnalogscaleVAS)法评定镇痛效果(0～10分)。结果:B组的PCA数明显多于A组,曲马多的用量少于A组(t=-2.5,P<0.05)。B组嗜睡、呕吐不良反应少于A组。结论:赖氨比林复合曲马多可减少曲马多的用量,并降低曲马多嗜睡、呕吐的发生,赖氨比林复合曲马多是一种安全有效的镇痛方式。

AIM:To observe the analgesic effect and the incidence of adverse effects of tramadol plus lysine acetyl salicylate(LAS) used for patient controlled analgesia(PCA). METHODS:Thirty adult patients,who had been operated by choosing different periods,were randomly divided into group A(tramadol) and group B(tramadol+LAS)(15 cases in each group).All the patients were performed with combined spinal epidural anesthesia(CSEA).After operation,all the patients were performed with patient controlled analgesia(PCA) by mainline.At the end of wound closure, the dose of either tramadol 2.5 mg/L(group A) or tramadol 1.25 mg/L+LAS 12.5 mg/L mixture(group B)was administered slowly.The patients were administrated when they felt pain,and the time for administration,dosage of mediation and adverse effects were assessed every 6 hours continuously for 48 hours.Visual Analog scale(VAS) were used to depict the analgesic effect(scores 1-10). RESULTS:The number of PCA was significantly more in group B than in group A,while the dosage was less in group B than in group A(t=-2.5,P< 0.05). The incidences of drowse and nausea/vomiting in group B were significantly less than those in group A. CONCLUSION:PCA with a mixture of tramadol plus LAS can decrease the dosage of tramadol and the incidence of drowse and nausea/vomiting.It is an effective and safe analgesic method using tramadol plus LAS after orthopedic surgery.