摘要
目的研究术前口服盐酸曲马多缓释片对腹腔镜胆囊切除术患者术后急性疼痛的影响。方法选择择期行腹腔镜下胆囊切除术患者60例,ASA分级Ⅰ～Ⅱ级,随机分成两组(n=30):实验组(术前口服盐酸曲马多缓释片)和对照组(术前口服维生素C片);记录T0(术后即刻)、T1(入麻醉恢复室后30min)、T2(入麻醉恢复室后1h)、T3(术后6h)、T4(术后12h)、T5(术后24h)、T6(术后48h)时点视觉模拟评分(VAS)和芬太尼使用情况。结果实验组和对照组手术时间和麻醉苏醒时间比较,差异均无统计学意义(t分别=0.69、0.70,P均>0.05)。与对照组比较,实验组术后早期T0～T2时点出现VAS评分减少,差异均有统计学意义(t分别=2.11、2.23、2.30,P均<0.05),T3～T6时点两组VAS评分比较,差异均无统计学意义(t分别=0.77、1.23、0.96、0.89,P均>0.05)。实验组芬太尼用量减少,其用量为0,而对照组用量为(35.02±12.77)μg,差异有统计学意义(t=3.26,P<0.05)。两组患者术后均未出现严重不良反应。结论术前口服一定剂量盐酸曲马多缓释片可减轻腹腔镜胆囊切除术患者术后早期急性疼痛。
Objective To investigate the effects of tramadol controlled release tablets pretreatment on acute pain in patients after laparoscopic cholecystectomy.Methods Sixty patients undergoing laparoscopic cholecystectomy（LC） under general anesthesia were randomly divided into 2 groups（n=30 each）.Test group：tramadol controlled release tablets pretreatment;control group：vitamine C as a placebo control.Pain was controlled by intermittent intravenous boluses of fentanyl in PACU,and the fentanyl consumption was recorded.VAS scores were recorded at 7 time points：T0（the time when a patient just went to PACU）,and 30 min,60 min,6 hours,12 hours,24 hours,48 hours after operation（T1,T2,T3,T4,T5,T6）.Results There were no significant difference in the operation time and anaesthesia emergence time between the 2 groups（t=0.69,0.70,P0.05）.During the first hour（T0-T2） after operation at PACU the VAS scores and fentanyl consumption were significantly higher in control group than those in the test group（t = 2.11,2.23,2.30,3.26,P0.05）.There was no significant difference in VAS during 6-48 hours after operation in ward between the 2 groups（t=0.77,1.23,0.96,0.89,P0.05）.There was on serious adverse reaction occurred in 2 groups.Conclusions Pretreatment with tramadol controlled release tablets 500 mg can safely lessen early acute pain in patients after laparoscopic cholecystectomy.
出处
《全科医学临床与教育》
2010年第6期638-640,共3页
Clinical Education of General Practice
关键词
盐酸曲马多
缓释片
腹腔镜胆囊切除术
tramadol hydrochloride
controlled release tablets
laparoscopic cholecystectomy
