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硬膜外与静脉注射曲马多输注用于术后镇痛的随机双盲比较

[A randomized double-blind comparison of epidural versus intravenous tramadol infusion for postoperative analgesia].

作者信息

Ijichi Kazuko, Nijima Kuniyuki, Iwagaki Tamao, Irie Jun, Uratsuji Yuko

机构信息

Department of Anesthesiology, Nishikobe Medical Center, Kobe.

出版信息

Masui. 2005 Jun;54(6):615-21.

Abstract

BACKGROUND

This study compared epidural and intravenous tramadol infusions for postoperative analgesia after gastrectomy.

METHODS

Twenty patients were assigned randomly to receive either tramadol epidurally and saline intravenously (group-E) or tramadol intravenously and saline, epidurally (group-I) in a double-blind fashion. At the end of the operation, each patient received a bolus of tramadol 2 mg x kg(-1) either epidurally or intravenously and 7 mg x kg(-1) x day(-1) tramadol infusion was begun via the same route. Concurrently, a saline bolus and its infusion were given via the alternate route.

RESULTS

Both groups obtained adequate pain relief and there was no difference between the groups in pain score. But one patient in E-group was excluded from the study for respiratory depression 8 hours after the operation. No other side effects were detected in either group except mild nausea.

CONCLUSIONS

We conclude that intravenous tramadol infusion provides effective and safe postoperative analgesia. A futher examination is required for the suitable dose of tramadol in epidural infusion.

摘要

背景

本研究比较了胃切除术后硬膜外和静脉输注曲马多的术后镇痛效果。

方法

20例患者被随机双盲分配,分别接受硬膜外输注曲马多和静脉输注生理盐水(E组),或静脉输注曲马多和硬膜外输注生理盐水(I组)。手术结束时,每位患者通过硬膜外或静脉途径接受2mg/kg曲马多的负荷剂量,并开始通过相同途径以7mg·kg⁻¹·d⁻¹的剂量输注曲马多。同时,通过另一条途径给予生理盐水负荷剂量及其输注。

结果

两组均获得了充分的疼痛缓解,两组之间的疼痛评分无差异。但E组有1例患者在术后8小时因呼吸抑制被排除在研究之外。除轻度恶心外,两组均未检测到其他副作用。

结论

我们得出结论,静脉输注曲马多可提供有效且安全的术后镇痛。硬膜外输注曲马多的合适剂量需要进一步研究。

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