Ng K F, Tsui S L, Yang J C, Ho E T
Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Eur J Anaesthesiol. 1998 Sep;15(5):565-70. doi: 10.1046/j.1365-2346.1998.00354.x.
Thirty-eight ASA I-III patients undergoing lower abdominal operations were randomly allocated to receive either morphine (group M, patient-controlled analgesia bolus = 1 mg of morphine) or tramadol (group T, patient-controlled analgesia bolus = 10 mg of tramadol) for post-operative patient-controlled analgesia (PCA) after receiving morphine intraoperatively. There were no between-group differences in the pain, sedation or vomit scores. The nausea scores were significantly higher in group T in the initial 20 h and between 32 and 36 h (P < 0.01, 0-4 and 8-12 h; P < 0.05, 4-8, 12-16, 16-20 and 32-36 h). The incidence of dizziness was also significantly higher in group T (68.4% vs. 31.6%, group T vs. group M, P < 0.05). There was no difference in the overall satisfaction. We conclude that the use of tramadol, compared with morphine, for post-operative PCA after intraoperative loading with morphine is associated with more nausea and dizziness, but with similar sedation, quality of analgesia and patient satisfaction.
38例接受下腹部手术的美国麻醉医师协会（ASA）分级为I-III级的患者，在术中接受吗啡后，被随机分配接受吗啡（M组，患者自控镇痛推注剂量=1mg吗啡）或曲马多（T组，患者自控镇痛推注剂量=10mg曲马多）用于术后患者自控镇痛（PCA）。两组在疼痛、镇静或呕吐评分方面无差异。T组在最初20小时以及32至36小时之间的恶心评分显著更高（P<0.01，0 - 4小时和8 - 12小时；P<0.05，4 - 8小时、12 - 16小时、16 - 20小时和32 - 36小时）。T组头晕的发生率也显著更高（T组 vs. M组，68.4% vs. 31.6%，P<0.05）。总体满意度无差异。我们得出结论，与吗啡相比，在术中使用吗啡负荷后，术后PCA使用曲马多会导致更多的恶心和头晕，但镇静、镇痛质量和患者满意度相似。
