Kiliçaslan Alper, Tuncer Sema, Yüceaktaş Ali, Uyar Mehmet, Reisli Ruhiye
Department of Anesthesiology, Selçuk University Meram Faculty of Medicine Konya, Turkey.
Agri. 2010 Jan;22(1):7-12.
In this study, the effects and side effects of intravenous paracetamol application, combined with patient-controlled intravenous tramadol analgesia, were investigated in elective cesarean operations for postoperative pain control and its tramadol-sparing effect.
Fifty ASA I-II patients scheduled for cesarean operation were enrolled in this study. Patients were randomly divided into two groups: group I served as a control group, with saline administration (100 ml) 15 min before the end surgery and every 6 h for 24 h, whereas group II received paracetamol (1 g/100 ml) at the stated time points. All patients received a standard anesthetic protocol. At the end of surgery, all patients received tramadol i.v. via a PCA (patient-controlled analgesia) device. Pain and sedation scores were assessed at 1, 3, 6, 12 and 24 h postoperatively.
Tramadol consumption and adverse effects were noted in the first 24 hours following surgery. The pain scores were significantly lower in the paracetamol group when compared with the control group (p<0.05). The cumulative tramadol consumption was lower in the paracetamol group than the control group (p<0.05). No significant difference was observed in sedation scores and nausea-vomiting scores between the groups (p>0.05).
We conclude that paracetamol is a safe and effective treatment option in post-cesarean pain for combination with tramadol, as it produces effective analgesia and reduces tramadol consumption.
本研究旨在探讨静脉注射对乙酰氨基酚联合患者自控静脉注射曲马多镇痛在择期剖宫产手术中对术后疼痛控制的效果及副作用，以及其对曲马多的节省作用。
本研究纳入了50例计划行剖宫产手术的ASA I-II级患者。患者被随机分为两组：I组作为对照组，在手术结束前15分钟给予生理盐水（100 ml），术后每6小时给予一次，共24小时；而II组在规定时间点给予对乙酰氨基酚（1 g/100 ml）。所有患者均接受标准麻醉方案。手术结束时，所有患者通过PCA（患者自控镇痛）装置静脉注射曲马多。术后1、3、6、12和24小时评估疼痛和镇静评分。
记录了术后24小时内曲马多的消耗量和不良反应。与对照组相比，对乙酰氨基酚组的疼痛评分显著更低（p<0.05）。对乙酰氨基酚组的曲马多累积消耗量低于对照组（p<0.05）。两组之间的镇静评分和恶心呕吐评分无显著差异（p>0.05）。
我们得出结论，对乙酰氨基酚与曲马多联合用于剖宫产术后疼痛是一种安全有效的治疗选择，因为它能产生有效的镇痛作用并减少曲马多的消耗量。
