摘要
目的评价曲马多复合不同剂量舒芬太尼用于胃肠外科患者术后静脉自控镇痛（patient controlled intravenous analgesia,PCIA）的效果。方法选择ASAⅠ或Ⅱ级择期行胃肠外科手术患者60例,按入院先后分为三组。A组：曲马多300 mg＋舒芬太尼50μg;B组：曲马多300 mg＋舒芬太尼100μg;C组：曲马多300 mg＋舒芬太尼150μg。三组镇痛药物均加入氟哌啶2.5 mg,用生理盐水稀释至100 ml。手术结束前连接自控镇痛泵（PCA）,镇痛模式为负荷剂量2 ml,背景输注剂量1.2 ml/h,单次给药剂量2 ml,锁定时间为20 min,全程观察24 h。分别于术后2∽4 h、8∽10 h、12∽20 h、22∽24 h记录患者视觉模拟评分法（VAS）评分、Ramsay镇静评分和不良反应。结果术后24 h各时段B、C两组VAS评分均低于A组（P=0.000）;与B组比较,C组8∽10 h、12∽20 h VAS评分均降低（P=0.000）;三组患者各时段Ramsay镇静评分差异无统计学意义（P〉0.05）。结论 300 mg曲马多复合150μg舒芬太尼用于胃肠外科手术后PCIA,效果较好,而且安全可靠。
Objective To evaluate the efficacy of postoperative patient controlled intravenous analgesia（ PCIA） with tramadol combined with different doses of sufentanil after gastrointestinal surgery. Methods According to admission date,60 patients undergoing gastrointestinal surgery were randomly divided into three groups with 20 patients in each group. Group A received tramadol 300 mg and sufentanil 50 μg. Group B received sufentanil 100 μg and tramadol 300 mg. Group C received tramadol 300 mg and sufentanil 150 μg. Analgesia drugs in each group were added droperidol 2. 5 mg and diluted with normal saline to 100 ml. Patient controlled analgesia（ PCA） pumps were connected before the end of operations. The mode of analgesia： the load dose was 2 ml,the maintenance dose was1. 2 ml / h,PCA was 2 ml and the locking time was 20 min. The whole observing course was 24 h. Visual analogue scale（ VAS）,Ramsay sedation score and side effects were recorded at 2 ∽ 4 h,8 ∽ 10 h,12 ∽ 20 h and 22 ∽ 24 h respectively after the operation. Results The VAS scores in group B and group C at each stage after the operation were lower than that in group A（ P = 0. 000）. The VAS score in group C at each stage was lower than that in group B after the operation（ P = 0. 000）. There was no significant difference in Ramsay sedation score at each stage after the operation among the three groups. Conclusion Tramadol 300 mg combined with sufentanil 150 μg is effective and safe for postoperative PCIA in patients undergoing gastrointestinal surgery.
出处
《中国临床新医学》
2015年第7期647-650,共4页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
胃肠疾病
手术
曲马多
舒芬太尼
静脉自控镇痛
Gastrointestinal diseases
Surgery
Tramadol
Sufentanil
Patient controlled intravenous analgesia（PCIA）
