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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:

06

期数:

2006年10期

页码:

800-802

栏目:

出版日期:

2006-10-30

文章信息/Info

Title:

Analgesic effects of preoperative caudal injection with tramadol in patients after receiving gynaecological laparoscopy undergeneral anesthesia

作者:

赵国胜; 徐丽; 张宁

首都医科大学附属北京妇产医院麻醉科,北京,100006

Author(s):

Zhao Guosheng;  Xu Li;  Zhang Ning.

Department of Anesthesiology, Bingjing Obstetrics & Gynecology Hospital of Capital University of Medical Sciences, Beijing 100006, China

关键词:

妇科腹腔镜; 骶管阻滞; 镇痛; 全麻; 曲马多

Keywords:

Gynaecological laparoscopy; 　Caudal block; 　Analgesia; 　General anesthesia; 　Tramadol

分类号:

R713;R614.4+1

文献标志码:

A

摘要:

目的 观察曲马多术前骶管阻滞用于妇科腹腔镜全麻术后镇痛的效果.方法 全麻下行妇科腹腔镜手术60例,随机分为2组,每组30例:A组术前经骶管注入含曲马多100 mg+2%利多卡因5 ml+恩丹西酮4 mg+生理盐水共20 ml溶液,B组手术结束前10 min由莫非氏壶滴入曲马多100 mg+恩丹西酮4 mg.采用VAS评分和Ramsay镇静评分对患者拔管后、离室前以及术后1、3、6 h进行痛觉和镇静程度评分,并记录有无躁动、头晕、嗜睡、恶心、呕吐等不良反应.结果 A组拔管后,离室前,术后1、3 h的VAS评分显著低于B组(t=-5.961,-8.362,-4.038,-3.565;P=0.000),术后6 h VAS评分2组无显著性差异(t=-1.403,P=0.166);A组患者的镇静评分在拔管后,离室前,术后1、3 h明显高于B组(t=9.409,10.407,8.167,4.082;P=0.000),2组术后6 h的镇静程度评分无显著性差异(t=0.428,P=0.670).B组患者拔管后、离室前躁动及术后头晕、恶心、呕吐的发生率明显高于A组(χ2=12.000,P=0.001;χ2=9.600,P=0.002;χ2=13.017,P=0.000).结论 曲马多100 mg术前骶管阻滞是妇科腹腔镜全麻术后较好的镇痛方法之一.

Abstract:

Objective　To observe the analgesic effects of preoperative tramadol caudal injection in patients after receiving gynaecological laparoscopy under general anesthesia.　M ethods　A total of 60 patients scheduled for gynaecological laparoscopic operations under general anesthesiawas randomly divided into two groupswith 30 patients each. TheGroupAwas given an injection of tramadol100 mg, 2% lidocaine 5 m,l ondansetron 4 mg, and normal saline 20 ml by caudal route preoperatively, while theGroup B was given an intravenous drip of tramadol100 mg and ondansetron 4 mg at10 minutes before the end of operation. TheVisualAnalog Scale (VAS) pain scores and the Ramsay Sedation Scoreswere recorded after extubation, before the departure from operation room, and at1, 3, and 6 hours after surgery, respectively. Adverse effects of dysphoria, dizziness, drowsiness, nausea, and vomitingwere recorded.　Results　TheVAS scoreswere significantly lower after extubation, before the departure from operation room, and at1 and 3 hours after surgery in the Group A than in the Group B (t=-5.961,-8.362,-4.038,-3.565;P=0. 000), while the differencewas not significantbetween the two groups at 6 hours after surgery (t=-1·403, P=0. 166). The Ramsay scores were significantl higher after extubation, before the departure from operation room, and at1 and 3 hours after surgery in theGroupA than in the Group B (t=9.409,10.407,8.167,4.082;P=0.000), while the differencewas notsignificantbetween the two groups at6 hours after surgery (t=0.428, P=0.670). Significantlymore patients presented dysphoria, dizziness, nausea, and vomiting in the Group B than in the Group A after extubation and before the departure from operation room.　Conclusions　Tramadol 100 mg caudal injection before operation can produce a better postoperative analgesic effect in patients receiving gynaecological laparoscopic operations.

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更新日期/Last Update: 2014-03-03