中华麻醉学杂志
中華痳醉學雜誌
중화마취학잡지
CHINESE JOURNAL OF ANESTHESIOLOGY
2010年
2期
150-152
,共3页
吴城%肖旺频%程惠平%姚明
吳城%肖旺頻%程惠平%姚明
오성%초왕빈%정혜평%요명
曲马朵%迟效制剂%投药,口服%哌啶类%药物耐受性
麯馬朵%遲效製劑%投藥,口服%哌啶類%藥物耐受性
곡마타%지효제제%투약,구복%고정류%약물내수성
Tramadol%Delayed-action preparations%Administration,oral%Piperidines%Drug tolerance
目的 评价术前口服曲马多缓释剂对靶控输注瑞芬太尼复合麻醉病人术后急性阿片类药物耐受的影响.方法 择期拟行腹腔镜胆囊切除术病人60例,ASA Ⅰ或Ⅱ级,年龄18～64岁,随机分为2组(n=30):安慰剂组(C组)和曲马多组(T组).C组于术前48、36、24、12、0.5 h时口服维生素C片1片(100 mg),T组于相同时点口服曲马多缓释片1片(100 mg),共计500 mg.两组均采用靶控输注瑞芬太尼和异丙酚复合麻醉,拔除气管导管后在麻醉恢复室(PACU)观察1h送返病房.PACU内静脉注射芬太尼5～10μg,5 min后重复注射,维持VAS评分＜4分.病房内采用10 μg/ml芬太尼100 ml行PCIA(负荷量10μg、背景输注速率20 μg/h、PCA剂量5μg、锁定时间15 min).记录PACU内芬太尼用量、术后48 h内PCIA芬太尼用量、有效按压次数(D_1)和实际按压次数(D_2),计算D_1/D_2比值.结果 与C组比较,T组术后PACU内芬太尼用量减少(P＜0.05),术后48 h内PCIA芬太尼用量和D_1/D_2比值差异无统计学意义(P＞0.05).结论 术前口服500 mg曲马多缓释剂可减轻靶控输注瑞芬太尼复合麻醉病人术后急性阿片类药物耐受.
目的 評價術前口服麯馬多緩釋劑對靶控輸註瑞芬太尼複閤痳醉病人術後急性阿片類藥物耐受的影響.方法 擇期擬行腹腔鏡膽囊切除術病人60例,ASA Ⅰ或Ⅱ級,年齡18～64歲,隨機分為2組(n=30):安慰劑組(C組)和麯馬多組(T組).C組于術前48、36、24、12、0.5 h時口服維生素C片1片(100 mg),T組于相同時點口服麯馬多緩釋片1片(100 mg),共計500 mg.兩組均採用靶控輸註瑞芬太尼和異丙酚複閤痳醉,拔除氣管導管後在痳醉恢複室(PACU)觀察1h送返病房.PACU內靜脈註射芬太尼5～10μg,5 min後重複註射,維持VAS評分＜4分.病房內採用10 μg/ml芬太尼100 ml行PCIA(負荷量10μg、揹景輸註速率20 μg/h、PCA劑量5μg、鎖定時間15 min).記錄PACU內芬太尼用量、術後48 h內PCIA芬太尼用量、有效按壓次數(D_1)和實際按壓次數(D_2),計算D_1/D_2比值.結果 與C組比較,T組術後PACU內芬太尼用量減少(P＜0.05),術後48 h內PCIA芬太尼用量和D_1/D_2比值差異無統計學意義(P＞0.05).結論 術前口服500 mg麯馬多緩釋劑可減輕靶控輸註瑞芬太尼複閤痳醉病人術後急性阿片類藥物耐受.
목적 평개술전구복곡마다완석제대파공수주서분태니복합마취병인술후급성아편류약물내수적영향.방법 택기의행복강경담낭절제술병인60례,ASA Ⅰ혹Ⅱ급,년령18～64세,수궤분위2조(n=30):안위제조(C조)화곡마다조(T조).C조우술전48、36、24、12、0.5 h시구복유생소C편1편(100 mg),T조우상동시점구복곡마다완석편1편(100 mg),공계500 mg.량조균채용파공수주서분태니화이병분복합마취,발제기관도관후재마취회복실(PACU)관찰1h송반병방.PACU내정맥주사분태니5～10μg,5 min후중복주사,유지VAS평분＜4분.병방내채용10 μg/ml분태니100 ml행PCIA(부하량10μg、배경수주속솔20 μg/h、PCA제량5μg、쇄정시간15 min).기록PACU내분태니용량、술후48 h내PCIA분태니용량、유효안압차수(D_1)화실제안압차수(D_2),계산D_1/D_2비치.결과 여C조비교,T조술후PACU내분태니용량감소(P＜0.05),술후48 h내PCIA분태니용량화D_1/D_2비치차이무통계학의의(P＞0.05).결론 술전구복500 mg곡마다완석제가감경파공수주서분태니복합마취병인술후급성아편류약물내수.
Objective To investigate the effect of preoperative administration of tramadol controlled release tablets on postoperative acute opioid tolerance in patients after remifentanil-based anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 18-64 yr undergoing laparoscopic cholecystectomy(LC)under general anesthesia were randomly divided into 2 groups(n = 30 each): placebo control group(group C)and tramadol controlled release tablets group(group T).In group C vitamin C tablets 100 mg was taken orally 48,36,24,12,0.5 h before operation and in group T tramedol controlled release tablets 100 mg was administered orally at the same time points respectively.Anesthesia was induced and maintained with TCI of remifentanil(Cp 1.5-6.0 ng/ml)and propofol(Cp 2.5-4.5 μg/ml).The patients were observed in PACU for 1 h after LC and then transferred to the ward.Postoperative pain was controlled by intermittent iv boluses of fentanyl in PACU.Patient-controlled intravenous analgesia(PCIA)with fentanyl(loading dose 10 μg,background infusion 20 μg/h,bolus dose 5 μg,lockout interval 15 min)was used in the ward.Fentanyl consumption in PACU during the first hour after operation was recorded.Fentanyl consumption of PCIA,the number of successful delivered doses(D_1)and the number of attempts(D_2)in the ward during the 48 h after operation were recorded.D_1/D_2 ratio was calculated.Results Fentanyl consumption was significantly lower in group T than in group C during the first hour after operation in PACU(P＜0.05).There was no significant difference in fentanyl consumption of PCIA and D_1/D_2 ratio during the48 h after operation between the two groups(P＞0.05).Conclusion Preoperative administration of tramadol controlled release tablets(500 mg)can effectively alleviate early postoperative acute opioid tolerance induced by remifentanil-based anesthesia.
