摘要
目的 探讨曲马多对女性子宫相关全麻手术后导尿管相关膀胱刺激征(CRBD)的影响。方法 在2024年5月—11月在本院计划接受子宫相关全麻手术的患者中招募研究对象。本研究共计划纳入176例,所有患者均在气管插管下实施全身麻醉。随机化分为两组,少数患者(共计4例)中途不配合退出,最后对照组(10 mL生理盐水)为85例,曲马多组(等剂量浓度为10 mg/mL)为87例。主要观察指标为T0~T3不同时间点CRBD发生率及中重度率。次要观察指标包括疼痛视觉模拟评分(VAS)、Ramsay镇静评分和术后不良反应等。组间用t检验、卡方检验或Fisher检验,并采用Benjamini-Hochberg FDR方法进行多重比较校正。结果 与对照组相比,曲马多组在各时间点CRBD发生率及中重度率均降低(T0和T1时间点差异均具有统计学意义,P<0.05)。术后疼痛VAS评分方面,曲马多组显著低于对照组(P<0.001),但两组镇静Ramsay评分无明显差异。术后不良反应如低氧血症、心动过缓及苏醒延迟在曲马多组的发生率低于对照组,但差异未达统计学意义(P>0.05)。结论 曲马多可显著降低子宫相关全麻后CRBD的发生率和严重程度,缓解术后疼痛,同时未引起明显的镇静、恶心或呕吐等不良反应,展现出良好的疗效和安全性。
Objective To investigate the effects of tramadol on catheter-related bladder discomfort(CRBD)in women undergoing uterine-related surgeries under general anesthesia.Methods From May to November 2024,patients scheduled for uterine-related surgeries under general anesthesia at our hospital were recruited.A total of 176 patients,all under general anesthesia with endotracheal intubation,were planned for inclusion.Participants were randomized into two groups:the control group(10 mL saline,n=85)and the tramadol group(tramadol 10 mg/mL,n=87).Four patients withdrew due to non-compliance.Primary outcomes included CRBD incidence and severity at various time points(T0–T3).Secondary outcomes included visual analog scale(VAS)pain scores,Ramsay sedation scores,and postoperative adverse events.Statistical analyses involved t-tests,chi-square tests,or Fisher's exact tests,with multiple comparisons corrected using the Benjamini-Hochberg false discovery rate(FDR)method.Results Compared with the control group,the tramadol group demonstrated lower CRBD incidence and severity at all time points,with statistically significant differences at T0 and T1(P<0.05).Postoperative VAS pain scores were significantly lower in the tramadol group(P<0.001),while Ramsay sedation scores showed no significant difference between groups.The incidence of postoperative adverse events,such as hypoxemia,bradycardia,and delayed recovery,was lower in the tramadol group,although the differences were not statistically significant(P>0.05).Conclusion Tramadol significantly reduces the incidence and severity of CRBD following uterine-related surgeries under general anesthesia,alleviates postoperative pain,and does not cause notable sedation,nausea,or vomiting.These findings highlight its efficacy and safety in clinical practice.
作者
王芳
陈千
陈紫琪
钱斌
WANG Fang;CHEN Qian;CHEN Ziqi;QIAN Bin(Yancheng Clinical College,Xuzhou Medical University,Yancheng,Jiangsu 224006;Department of Anesthesiology,Yancheng First People's Hospital,Yancheng,Jiangsu 224006)
出处
《智慧健康》
2025年第13期79-83,共5页
Smart Healthcare
基金
盐城市基础研究计划指导性项目《ADRB3活化介导血脊髓屏障破坏在术前应激致术后慢性疼痛中的作用机制研究》(项目编号:YCBK202208)
江苏医药职业学院第一附属医院青年科研人才培育项目《β3肾上腺素能受体调节棕色脂肪分泌IL-6在术前应激诱导术后慢性疼痛中的作用机制》(项目编号:QN2022001)。
关键词
曲马多
导尿管相关膀胱刺激症状
子宫相关全麻手术
Tramadol
Catheter-Related bladder discomfort
General anesthesia for uterine-Related surgery
