Chen T P, Hwang T I, Yu C T, Yang C R, Chang C L, Change C H, Wu H C, Ou Y C
Department of Surgery, Taichung, Veterans General Hospital, R.O.C.
Zhonghua Yi Xue Za Zhi (Taipei). 1993 Feb;51(2):134-7.
Since its introduction, extracorporeal shock-wave lithotripsy (ESWL) has become the treatment of choice in patients with urinary calculi. But the pain during ESWL is intolerable for many patients. Tramadol HCL resembles morphine in that it depresses motor and sensory responses of the spinal nociceptive system by a spinal and a supraspinal action. The side effects of tramadol are less than morphine. A prospective study was performed to determine the effect of tramadol in ESWL for the patients with urinary tract calculi. Ninety patients were randomized divided into three groups. Group A 40 patients (male:female = 31:9) received oral tramadol HC1 100 mg; group B 17 patients (male:female = 12.5) received multi-vita; group C 33 patients (male:female = 26:7) received analgesic (contained aspirin 399 mg and codeine phosphate 15 mg). The patients took the drugs 30 minutes before ESWL. The patients with renal calculi > 2 cm in diameter or ureteral calculi > 1 cm in diameter were excluded. The lithotriper used in our hospital is Siemens Lithostar. According to the description of the patients postoperatively, the pain intensity during ESWL was identified with Verbal Scale and Visual Analogue Scale (VAS). The statistical method is one-way ANOVA. Statistical difference is significant when p < 0.05. The mean age of patients group A is 46.5 +/- 17.1, group B 45.5 +/- 14.4, and group C 50.5 +/- 14.6. The mean diameter of urinary calculi of group A is 0.98 +/- 0.41 cm, group B 1.09 +/- 0.33, and group C 1.06 +/- 0.43.(ABSTRACT TRUNCATED AT 250 WORDS)
自体外冲击波碎石术（ESWL）问世以来，它已成为尿路结石患者的首选治疗方法。但许多患者在ESWL治疗期间的疼痛难以忍受。盐酸曲马多与吗啡相似，它通过脊髓和脊髓上的作用抑制脊髓伤害感受系统的运动和感觉反应。曲马多的副作用比吗啡少。进行了一项前瞻性研究，以确定曲马多在尿路结石患者ESWL治疗中的效果。90例患者随机分为三组。A组40例患者（男∶女 = 31∶9）口服100 mg盐酸曲马多；B组17例患者（男∶女 = 12∶5）服用多种维生素；C组33例患者（男∶女 = 26∶7）服用镇痛药（含阿司匹林399 mg和磷酸可待因15 mg）。患者在ESWL治疗前30分钟服药。排除直径>2 cm的肾结石或直径>1 cm的输尿管结石患者。我院使用的碎石机是西门子Lithostar。根据患者术后描述，采用言语量表和视觉模拟量表（VAS）确定ESWL治疗期间的疼痛强度。统计方法为单因素方差分析。当p<0.05时，统计差异具有显著性。A组患者的平均年龄为46.5±17.1岁，B组为45.5±14.4岁，C组为50.5±14.6岁。A组尿路结石的平均直径为0.98±0.41 cm，B组为1.09±0.33 cm，C组为1.06±0.43 cm。（摘要截短于250字）
