国际麻醉学与复苏杂志
國際痳醉學與複囌雜誌
국제마취학여복소잡지
INTERNATIONAL JOURNAL OF ANESTHESIOLOGY AND RESUSCITATION
2012年
1期
22-25
,共4页
曲马朵%镇痛,患者控制%镇痛药
麯馬朵%鎮痛,患者控製%鎮痛藥
곡마타%진통,환자공제%진통약
Tramadol%Analgesia,patient-controlled%Analgesics
目的 比较曲马多麻醉诱导后和手术结束前综合给药方案与单纯手术结束前给药对于开腹手术术中镇静程度,麻醉苏醒质量以及术后镇痛效果和副作用的影响,探讨适合开腹手术的曲马多术中应用方案.方法 选择60例开腹手术患者,通过电脑生成的随机数字表将患者分为曲马多麻醉诱导后和手术结束前给药组(A组)以及曲马多手术结束前给药组(B组).A组于气管插管后和手术结束前30 min分别给予曲马多1.5 mg/kg,B组仅手术结束前30 min给予曲马多1.5 mg/kg.记录并比较两组术中给予曲马多前后双频谱指数(bispectral index,BIS)值变化,麻醉苏醒,术后镇痛的视觉模拟评分(visual analogue scale,VAS)和术后恶心呕吐(postoperative nausea and vomiting,PONV)、镇静评分、头晕等情况.结果 两组患者一般情况差异无统计学意义.术中曲马多1.5 mg/kg给药前后BIS值变化差异无统计学意义,两组患者麻醉苏醒和完全清醒时间以及相应B1S值差异无统计学意义(P＞0.05).术后0.5、2、6、12 hVAS评分,A组优于B组[不同时点VAS评分A组为(3.4±0.5)、(3.2±0.5)、(3.1±0.4)和(3.1±0.4)；组B为(3.9±0.6)、(3.6±0.6)、(3.4±0.6)和(3.4±0.5),P＜0.05或P＜0.01]；24 h及48 h两组差异无统计学意义.术后镇静评分,补救用药,有无PONV,头晕等情况两组差异无统计学意义. 结论 麻醉诱导后和手术结束前联合应用曲马多较单纯手术结束前应用曲马多有助于改善术后0.5 h～12 h镇痛效果,且未增加副作用.
目的 比較麯馬多痳醉誘導後和手術結束前綜閤給藥方案與單純手術結束前給藥對于開腹手術術中鎮靜程度,痳醉囌醒質量以及術後鎮痛效果和副作用的影響,探討適閤開腹手術的麯馬多術中應用方案.方法 選擇60例開腹手術患者,通過電腦生成的隨機數字錶將患者分為麯馬多痳醉誘導後和手術結束前給藥組(A組)以及麯馬多手術結束前給藥組(B組).A組于氣管插管後和手術結束前30 min分彆給予麯馬多1.5 mg/kg,B組僅手術結束前30 min給予麯馬多1.5 mg/kg.記錄併比較兩組術中給予麯馬多前後雙頻譜指數(bispectral index,BIS)值變化,痳醉囌醒,術後鎮痛的視覺模擬評分(visual analogue scale,VAS)和術後噁心嘔吐(postoperative nausea and vomiting,PONV)、鎮靜評分、頭暈等情況.結果 兩組患者一般情況差異無統計學意義.術中麯馬多1.5 mg/kg給藥前後BIS值變化差異無統計學意義,兩組患者痳醉囌醒和完全清醒時間以及相應B1S值差異無統計學意義(P＞0.05).術後0.5、2、6、12 hVAS評分,A組優于B組[不同時點VAS評分A組為(3.4±0.5)、(3.2±0.5)、(3.1±0.4)和(3.1±0.4)；組B為(3.9±0.6)、(3.6±0.6)、(3.4±0.6)和(3.4±0.5),P＜0.05或P＜0.01]；24 h及48 h兩組差異無統計學意義.術後鎮靜評分,補救用藥,有無PONV,頭暈等情況兩組差異無統計學意義. 結論 痳醉誘導後和手術結束前聯閤應用麯馬多較單純手術結束前應用麯馬多有助于改善術後0.5 h～12 h鎮痛效果,且未增加副作用.
목적 비교곡마다마취유도후화수술결속전종합급약방안여단순수술결속전급약대우개복수술술중진정정도,마취소성질량이급술후진통효과화부작용적영향,탐토괄합개복수술적곡마다술중응용방안.방법 선택60례개복수술환자,통과전뇌생성적수궤수자표장환자분위곡마다마취유도후화수술결속전급약조(A조)이급곡마다수술결속전급약조(B조).A조우기관삽관후화수술결속전30 min분별급여곡마다1.5 mg/kg,B조부수술결속전30 min급여곡마다1.5 mg/kg.기록병비교량조술중급여곡마다전후쌍빈보지수(bispectral index,BIS)치변화,마취소성,술후진통적시각모의평분(visual analogue scale,VAS)화술후악심구토(postoperative nausea and vomiting,PONV)、진정평분、두훈등정황.결과 량조환자일반정황차이무통계학의의.술중곡마다1.5 mg/kg급약전후BIS치변화차이무통계학의의,량조환자마취소성화완전청성시간이급상응B1S치차이무통계학의의(P＞0.05).술후0.5、2、6、12 hVAS평분,A조우우B조[불동시점VAS평분A조위(3.4±0.5)、(3.2±0.5)、(3.1±0.4)화(3.1±0.4)；조B위(3.9±0.6)、(3.6±0.6)、(3.4±0.6)화(3.4±0.5),P＜0.05혹P＜0.01]；24 h급48 h량조차이무통계학의의.술후진정평분,보구용약,유무PONV,두훈등정황량조차이무통계학의의. 결론 마취유도후화수술결속전연합응용곡마다교단순수술결속전응용곡마다유조우개선술후0.5 h～12 h진통효과,차미증가부작용.
Objective To compare the anesthesic depth,postoperative analgesia and side-effects between patients who received double doses of intraoperative tramadol when on induction and near the end of the operation,and those who received single dose of tramadol only near the end of the operation.Methods Sixty patients undergoing laparotomy were involved in this study and randomly divided into 2 groups by using a computer-generated random number table.The patiens in group A received 1.5 mg/kg tramadol for twice when on induction and 30 min before the end of the operation.And the patiens in group B received a single dose of 1.5 mg/kg tramadol 30 min before the end of the operation.bispectral index(BIS)was recorded before and after tramadol administration.The recovery from anesthesia,visual analogue scale(VAS)and side-effects of postoperative analgesia were monitored.Results There was no difference in the baseline characteristics between two groups.BIS were comparable before and after tramadol administration in both groups(P＞0.05).VAS was significantly lower in group A than in group B at the time of postoperative 0.5,2,6 h and 12 h,respectively(VAS 3.4±0.5,3.2±0.5,3.1±0.4 and 3.1±0.4 in group A vs 3.9±0.6,3.6±0.6,3.4±0.6 and 3.4±0.5 in group B correspondingly,P＜0.05 or P＜0.01),while there was no difference at the time of postoperative 24 h or 48 h.Ramsay scores,incidence of postopertive nausea and vomiting(PONV),dizziness,and supplemental analgesics did not show different between groups.Conclusions The double-dose protocol of intraoperative tramadol administered when on induction and near the end of the operation showed better postoperative analgesia without increasing the side-effects in the first postoperative 12 h.
