曲马多术后镇痛对妇科腹腔镜手术患者全麻恢复的影响

Influence of postoperative analgesia with tramadol to patients on recovery from general anaesthesia of gynecological laparoscope operation

  • 摘要: 目的: 观察曲马多作为妇科腹腔镜瑞芬太尼、丙泊酚全静脉麻醉术后镇痛药物对患者麻醉恢复的影响。方法: 将80例患者随机分为曲马多组40例,芬太尼组40例,分别使用曲马多或芬太尼作为术后镇痛药物,观察两组患者在麻醉恢复室的血流动力学变化,观察自主呼吸恢复时间、呼吸机使用时间,语言、定向、理解力恢复时间,总恢复室治疗时间,疼痛视觉模拟评分(VAS),恶心、呕吐,苏醒期躁动等指标。结果: 曲马多组自主呼吸恢复时间、呼吸机使用时间,语言、定向、理解力恢复时间及总恢复室治疗时间均短于芬太尼组(P<0.01),芬太尼组苏醒期躁动较多(P<0.01),曲马多组血流动力学更加稳定(P<0.01),术后1h、离室时VAS评分,恶心、呕吐两组差异无统计学意义(P>0.05)。结论: 曲马多作为全麻妇科腹腔镜术后镇痛药物优于芬太尼。

     

    Abstract: Objective: To compare influence of postoperative recovery with tramadol or fentanyl analgesia in general anesthesia of gynecological laparoscope operation which used propofol and remifentanil. Methods: 80 gynecologic patients undergoing laparoscopic surgery were randomized to two groups according to postoperative analgesics: fentanyl group (group F, n=40) and tramadol group (group T, n=40). The haemodynamic diversity, spontaneously breathing recovery time, vent use time, VAS score, analepsia phase restlessness, nausea and vomit, total time of PACU therapy were observed. The recovery time of speech, perceptual and direction location ability were recorded. Results: Group T was shorter in recovery time of spontaneously breathing, vent use time, total time of PACU therapy (P<0.01); The recovery time of speech, direction location and perceptual ability were shorter than group F too (P<0.01). The haemodynamic diversity was more steady in group T(P<0.01); analepsia phase restlessness was increased in group F; VAS score, nausea and vomit were no difference (P>0.05). Conclusion: Tramadol are more suitable than fentanyl as postoperative analgesics in general anesthesia of gynecological laparoscope operation.

     

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