摘要
背景与目的:吗啡用于术后镇痛时虽然疗效肯定,但副作用较多。曲马多为一新合成的μ-阿片受体激动剂,其用于硬膜外镇痛时疗效、副作用等报道不多。本研究拟比较曲马多、吗啡及其联合用于硬膜外术后镇痛时的疗效及副作用。方法:120例腹部肿瘤手术病人随机分为曲马多组(T组,n=40)、吗啡组(M组,n=40)和曲马多、吗啡联合组(T+M组,n=40)行硬膜外术后48h持续、恒速镇痛。镇痛药配方:T组为曲马多12mg/kg+0.125%布比卡因100ml,M组为吗啡0.12mg/kg+0.125%布比卡因100ml,T+M组为曲马多6mg/kg+吗啡0.06mg/kg+0.125%布比卡因100ml。分别记录三组病人术后VAS评分、BCS舒适评分、病人满意度评分(GSS评分)及副作用。结果:三组VAS评分无差异(P>0.05),VAS>5分者,T组显著多于M组及T+M组(P<0.05)。BCS及GSS评分T+M组显著优于T组及M组(P<0.05)。恶心、呕吐发生率T+M组显著低于M组(P<0.05)。结论:曲马多术后硬膜外镇痛疗效与吗啡近似,但波动较大,用药剂量应个体化。曲马多、吗啡联合用药可获得满意的镇痛效果,显著减少恶心、呕吐等副作用的发生。
Background &Objective:Morphine is a widely used analgesic i n management of postoperative pain with well documented analgesic properties and side effects.Tramadol,a new s yntheticμ-opioid receptor agonist ,little is known about its efficacy and side effects when administered in epidural for pain relief.The aim of this study is to compare the efficacy and side effects of tramadol,morphine versus their combinatio n for postoperative analgesia.Methods:One hundred and twenty patients undergoing abdominal cancer surgery were assigned t o one of three groups randomly,trama dol group(Group T,n=40),morphine group(Group M,n=40)and combination of tramadol and morp hine group(group T +M,n=40),for postoperative analgesia.In group T,12mg /kg tramadol and 0.125%bupivacaine 100ml were used for 48h postoperative analgesia.In group M,0.12mg /kg morphine and 0.125%bupi vacaine 100ml;and in group T +M ,6mg /kg tramadol,0.12mg /kg morphine and0.125%.Bupivacaine 100ml were used for postoperative analgesia.Effic acy was assessed by comparing visual analog ue scale(VAS),Bruggman comfort score(BCS),global satisfaction score(GSS)at several time points over 48hours.Possible a dverse events were recorded.Results:There is no significant difference a mong three groups in VAS,but in group T,there are more patients whose VAS >5 score than those in group M and group T +M.BCS;GSS in group T +M are lower than that in group T and group M.The occurrence rate of nausea and vomiti ng in group T +M are lower than that in g roup M.Conclusions:The efficacy of tramadol in epidural postoperative analgesia is similar to that of morphine,but varied from patient to patie nt,so the dose of tramadol should be individualized.Combination of tramadol and morphin e can provide effective analgesia fo r postoperative pain and cause little adverse effect,especially reduce the occurrence r ate of nausea and vomiting.
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2002年第7期794-796,共3页
Chinese Journal of Cancer
