摘要
目的：观察曲马多在预防老年病人全麻手术后拔管不良反应临床效果。方法：择期行胃大部切除或胆囊切除手术老年患者60例，随机分为两组，曲马多组静注曲马多2mg／kg（生理盐水稀释到5m1），2min注完，3min后停用维持麻醉药物，对照组则注射生理盐水。观察比较两组患者围术期血流动力学改变（平均动脉压（MAP）、心率（HR））及拔管前后SPO2变化及拔管后的不适反应。结果：在术毕，两组MAP、HR、SPO2差异无统计学意义（P〉0．05）。拔管即刻、拔管后5min、拔管后15min，曲马多组的MAP、HR明显低于对照组（P〈0．05）。组内比较，对照组HR、MAP在术毕和拔管后5min、15min明显高于术前（P〈0．05）。曲马多组在拔管即刻SPO2显著高于对照组（P〈0．05）。对照组拔管后呛咳12例，躁动11例，寒颤10例，切口疼痛21例；曲马多组拔管后呛咳1例，躁动2例，寒颤0例，切口疼痛6例，两组比较差异有统计学意义（P〈0．05）。结论：老年病人全麻手术患者麻醉苏醒期应用曲马多可减轻拔管不良反应，值得临床应用。
tramadol in observing the purpose of preventing the patient was out of the operation of reaction, methods the clinical effect ： toselecta- goodtime line with most of the removal or gallbladder big old age of the 60 cases randomly divided into two groups, the more quiet melody of the horse many 2rag kg （ saline water to dilute 5ml ）, 2rain note, 3min after, the drug with saline water, the injection, observation is the two groups of the patient＇s blood round the dynamics of change （ the map on the average （ ）, so heart rate （ hr ） ） and Spo and pull of two changes and took care of reaction. as a result, in art, the two groups of map and hr, spo 2 difference there is no statistical significance （ p O. 05 ）. unplug the matter, immediately, took care of, and draw after 5rain 15min, after the horse over the group hr the map and lower （ p 〈0. 05 ）. group hr, in comparison, the map and took control in HR 5rain, 15rain obvious than in the preoperative （ p 〈 0.05 ）. the horses are pulled more of an immediate spo two significantly higher than the （ P 〈0.05 ）. the pipe and draw after cough 12, flower 11 cases, chills 10 the pain is more than 21 cases ; the group took care and well after 1, 2 0 flower, chills, allowing 6 cases, the two groups of a difference there is a statistical significance （ p〈0.05 ）. conclusion： the patient all linen operation the patient to apply a rule of how to reduce the pull of the adverse reaction and clinical application.
关键词
老年
曲马多
全麻
拔管反应
age
tramadol
linen
effect of propofo of deuto-- anaesth dosage on extubated air tube
