CAJ | 학술논문

目的观察曲马多单独用于颞部入路开颅术后静脉自控镇痛（PCIA）的效果。方法选择120例择期颞部入路开颅手术患者，随机分为曲马多组（T组）、吗啡组（M组）各60例，术后行静脉自控镇痛（PCIA）。记录术后4、16、24、48h静息/运动状态的视觉模拟疼痛评分（VAS），镇痛泵按压次数，不良反应，补救用药。结果 VAS（静息）评分在术后4、16h，T组明显高于M组；VAS（运动）评分在术后4、16、48h，T组明显高于M组（P＜0.05）。PCA次数T组明显高于M组（P＜0.05）。补救用药，各种不良反应及呕吐发生率（T组51.7%，M组50.0%）差异均无统计学意义。结论曲马多用于神经外科开颅术后镇痛安全可靠，不增加术后恶心呕吐发生率。
목적관찰곡마다단독용우섭부입로개로술후정맥자공진통（PCIA）적효과。방법선택120례택기섭부입로개로수술환자，수궤분위곡마다조（T조）、마배조（M조）각60례，술후행정맥자공진통（PCIA）。기록술후4、16、24、48h정식/운동상태적시각모의동통평분（VAS），진통빙안압차수，불량반응，보구용약。결과 VAS（정식）평분재술후4、16h，T조명현고우M조；VAS（운동）평분재술후4、16、48h，T조명현고우M조（P＜0.05）。PCA차수T조명현고우M조（P＜0.05）。보구용약，각충불량반응급구토발생솔（T조51.7%，M조50.0%）차이균무통계학의의。결론곡마다용우신경외과개로술후진통안전가고，불증가술후악심구토발생솔。
Objective To observe the efifcacy tramadol in patient-controlled intravenous analgesia (PCIA)after temporal craniotomy approach. Methods One hundred and twenty patients undergoing temporal craniotomy surgery were equally randomized into two groups (n=60):Tramadol 1000mg(T) group, Morphine 30 mg (M) group and managed with patient-controlled intravenous analgesia. Visual analogue scale (resting/movement),analgesia pressing times,adverse reactions and drug remedy were evaluated at 4, 16, 24 and 48 h after surgery. Results VAS(resting) was higher in T group than in M group at 4,16 h and VAS(movement) was higher in T group than in M group at 4, 16, 48 h (P<0.05). Analgesia pressing times were higher in T group than in M group (P<0.05). There were no signiifcant difference between two groups with adverse reactions and drug remedy.The incidence of nausea and vomiting is 51.7%in T group and 50.0%in M group. Conclusion Tramadol can provide safe and reliable postoperative analgesia after craniotomy,does not increase the incidence of postoperative nausea and vomiting.