摘要
目的探讨曲马多对胸科手术患者术后炎症反应和术后镇痛效果的影响。方法该院收治的70例ASAⅠ、Ⅱ级开胸手术患者,按照数字随机表分为两组:曲马多组和对照组,每组35例。两组患者分别在术后行静脉镇痛,曲马多组镇痛药物配制:舒芬太尼100μg+曲马多12 mg/kg+赛格恩8 mg;对照组:舒芬太尼100μg+赛格恩8 mg。两组患者分别于术毕即刻(T_0)及术后4 h(T_2)、8 h(T_3)、12 h(T_4)、24 h(T_5)抽取静脉血样,测定血浆C反应蛋白(CRP)、白细胞介素-6(IL-6)和肿瘤坏死因子(TNF-α)和的浓度。采用视觉模拟评分法(VAS)评价术后2 h(T_1)、4 h(T_2)、8 h(T_3)、12 h(T_4)、24 h(T_5)的镇痛效应,及患者48 h内出现恶心、呕吐,皮肤瘙痒等不良反应例数。结果与对照组相比,曲马多组在T2-T4时点血浆IL-6、CRP浓度均显著降低,差异有统计学意义(P<0.05);与对照组相比,曲马多组血浆TNF-α浓度在各时点无明显变化,差异无统计学意义(P>0.05);与对照组比较,曲马多组在术后T_2、T_3和T_4视觉模拟疼痛评分降低,差异有统计学意义(P<0.05)。结论曲马多对胸科手术患者可产生良好的镇痛效果,减少围术期细胞因子的产生,同时减少围术期应激性激素的释放,有利于术后恢复。
[ Objective ] To investigate the postoperative analgesic effect and inflammatory reaction of tramadol in patients with thoracic surgery. [ Method ] 70 ASA I- II cases undergone thoracic surgery in our hospital were divided into two groups： the tramadol group and control group （n=35）. Two groups both were performed intravenous analgesia. Tramadol group preparation： sufentanil 100 p^g ＋ tramadol 12 mg/kg ＋ tropisetron 8 rag, control group： sufentanil 0.1 mg＋ tropisetron 8 rng. Blood samples of the two groups were collected at the end of surgery （T0） and after 4 h （T2）, 8 h （T3）, 12 h （T4）, 24 h （Ts） operation to test the plasma C-reactive protein （CRP）, leukocyte Interleukin -6 （IL-6） and tumor neerosis factor （TNF-） coneentration. Visual analogue scales （VAS） were used to evaluate the analgesic effect at 2 h （T1）, 4 h （T2）, 8 h （T3）, 12 h （T,）, 24 h （T5） and the symptom of nausea, vomiting, pruritus and other adverse reactions were also evaluated during 48 hours after operation. [ Results ] Compared with the control group, at T2-T4 point, the plasma coneentrations of IL-6 and CIRP in tramadol group were significantly lower, and the differ- enee was statistieally significant （P 〈0.01）, but there was no statisfieally significant difference in TNF-et eompared with the control group at each time point （P 〉0.05）. Compared with control group, VAS at T2, T3, T4, T5 decreased statisfieaUy significantly（P 〈0.05） in tramadol group. [ Conclusion ] For patients performed thoracie surgery, tramadol ean produee good analgesia, reduce perioperative cytokine production, and decrease the release of perioperafive stress hormone, whieh is conducive to postoperative recovery.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2011年第34期4329-4331,共3页
China Journal of Modern Medicine
