探析关腹前曲马多对上腹部术后患者早期恢复质量影响.docVIP

探析关腹前曲马多对上腹部术后患者早期恢复质量影响 　【关键词】 探讨 　　摘要：目的：探讨关腹前曲马多对上腹部术后患者早期恢复质量及并发症的影响。方法：42例上腹部择期手术患者（ASAⅠ～Ⅱ）随机均分为两组：T组（曲马多组）和C组（对照组）。T组于关腹前静脉给予曲马多（2mg/kg），C组给等量生理盐水。手术结束后患者在恢复室滞留90min，观察患者恢复质量（睁眼时间、拔管时间、定向力恢复时间、最大VAS评分、需要追加镇痛药患者例数）及并发症（恶心、呕吐、嗜睡、高血压、心动过速、呼吸抑制）。结果：两组患者术后呼名睁眼时间、拔管时间及定向力恢复时间差异无显著性（Pgt;0.05）；但T组的最大VAS评分远低于C组（Plt;0.05），观察期间需要追加阿片类镇痛药者例数也明显少于C组（Plt;0.05）。两组患者术后恶心、呕吐、高血压、心动过速、呼吸抑制等并发症的发生率差异无显著性（Pgt;0.05）。结论：关腹前曲马多（2mg/kg）有助于提高患者术后早期恢复质量而不增加并发症。 　　关键词：曲马多；全身麻醉；恢复质量 　　Wound Closure Tramadol Administration Improves Quality of Recovery without Increasing side Effects in the early Stage after Upper Abdominal Operation 　　QU LI-zhe,et al 　　(Shanghai TCM Hospital, Shanghai 200071, China) 　　Abstract：Objective: To evaluate the effects of tramadol administration at wound closure on recovery quality in patients undergoing upper abdominal surgery. Methods: 42 ASA I～II patients were allocated into two groups (n=20 in each) to receive either tramadol 2mg/kg (group T) or placebo saline (group C) iv at the time of wound closure. All patients stayed in recovery room for 90min before returning the ward , during this period, the times to eye opening, orientation, and tracheal extubation, as well as maximal pain score by VAS were observed; and the incidence of side effects including nausea/vomiting, tachycardia, hypertension, tachypnea, drowsiness and respiratory depression were also noted. Results: No statistically significant difference was found between the two groups in respect to the times to eye opening, orientation, and tracheal extubation (Pgt;0.05), but the maximal VAS score was markedly lower in group T than that in group C (Plt;0.01), and 5 patients in group T and 11 in group C required additional dose of analgesic to relieve pain in recovery room (Plt;0.01). The side effects were similar between the two groups. Conclusion: Wound closure tramadol (2mg/kg) administration improves analgesic effect without increasing side effects in the early stage after upper abdominal surgery.