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目的 观察曲马多在小儿咽部手术后镇痛的临床应用,对呼吸和循环功能的影响、镇痛效果、术后并发症情况,以探讨其可行性。方法 行扁桃体、腺样体切除手术的患儿40 例,随机分为两组,即对照组和镇痛组,每组20例,镇痛组手术后单次静注曲马多负荷量2mg/kg;对照组,单次静注生理盐水1ml。分别在术后1、4、8、12、24h观察患儿疼痛评分,同时监测患儿心率、收缩压、舒张压、脉搏血氧饱和度的变化,以及术后恶心呕吐、呼吸抑制、嗜睡等并发症的发生率。结果 术后1、4、8、12、24h的心率、收缩压、舒张压、脉搏血氧饱和度,两组与术前相比差异无显著意义(P>0.05)。术后1、4、8、12、24h的疼痛评分,镇痛组低于对照组,差异有显著意义(P<0.05)。两组患儿比较术后恶心呕吐、呼吸抑制、嗜睡等并发症的发生率差异无显著意义(P>0.05)。结论 手术后单次静注曲马多2mg/kg用于小儿咽部手术,镇痛效果明显,并发症少,方法简单易行,小儿易于接受。
Objective To observe the clinical application of tramadol in children with postoperative analgesia of pharyngeal surgery, respiratory and circulatory function, analgesic effect, postoperative complications, to explore its feasibility. Methods Forty children with tonsillectomy and adenoidctomy were randomly divided into two groups: control group and analgesia group, with 20 cases in each group. The patients in the analgesic group received a single intravenous tramadol loading of 2 mg / kg; control group, single intravenous injection of normal saline 1ml. The scores of pain in children were observed at 1, 4, 8, 12, and 24 hours after operation respectively. The changes of heart rate, systolic pressure, diastolic pressure and pulse oximetry in children were also monitored. Nausea and vomiting, respiratory depression, The incidence of complications. Results The heart rate, systolic blood pressure, diastolic blood pressure and pulse oximetry at 1, 4, 8, 12 and 24 hours after operation were not significantly different between the two groups (P> 0.05). Pain scores at 1, 4, 8, 12 and 24 hours after operation were lower in the analgesic group than in the control group, with significant difference (P <0.05). There was no significant difference in the incidence of postoperative nausea and vomiting, respiratory depression and lethargy among the two groups (P> 0.05). Conclusions Single tramadol 2mg / kg after operation for pediatric pharyngeal surgery has obvious analgesic effect and less complications. The method is simple and easy, and pediatric is easy to accept.