【摘要】　目的　 探討術(shù)中應用曲馬多、芬太尼對全麻蘇醒期鎮(zhèn)痛效果的影響。　方法　 2009年10月-2010年4月將80例靜脈麻醉下行胃癌根治術(shù)的患者隨機分為4組:Q1組曲馬多1 mg/kg、F1組芬太尼1 μg/kg、Q2組曲馬多2 mg/kg、F2組芬太尼2 μg/kg。各組分別于術(shù)畢前30 min靜注給藥。手術(shù)結(jié)束后送恢復室，比較4組的呼喚睜眼時間、拔管時間、拔管后即刻疼痛評分（VAS評分）、術(shù)前術(shù)后平均動脈壓（MAP）、心率（HR）、脈搏血氧飽和度（SpO2）的變化以及不良反應的發(fā)生情況。　結(jié)果　 4組患者呼喚睜眼時間差異無統(tǒng)計學意義（P gt;0.05），F(xiàn)2組的拔管時間明顯長于其他3組（P lt;0.05），Q1組和F1組的疼痛評分明顯高于Q2組和F2組（P lt;0.05），在T2時點，Q2組和F2組的MAP值明顯低于Q1組和F1組（P lt;0.05）。　結(jié)論　 曲馬多2 mg/kg與芬太尼2 μg/kg的鎮(zhèn)痛效果的效果相當，但安全性更高，更加適合全麻蘇醒期的鎮(zhèn)痛治療。
【Abstract】　Objective　 To investigate the effects of tramadol and fentanyl on analgesia in the early recovery period after general anesthesia.　Methods　 A total of 80 patients who underwent the operation of gastric cancer under general anesthesia from October 2009 to April 2010 were randomly divided into four groups: group Q1 received tramadol 1 mg/kg, group F1 received fentanyl 1 μg/kg, group Q2 received tramadol 2 mg/kg, and group F2 received fentanyl 2 μg/kg. Thirty minutes before the end of surgery, intravenous administration was performed on all of the patients. In the recovery room, the wake-up time, extubation time, pain level evaluated by Visual Analogue Scale (VAS), the mean arterial pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) before and after the surgery, and incidence of complications were recorded.　Results　 No significant differences in wake-up time among the four groups were found (P gt;0.05). The extubation time was longer in group F2 than that in the other three groups (P lt;0.05). The VAS scores in group Q1 and F1 were higher than those in group Q2 and F2. At the T2 time point, MAP in group Q2 and F2 were lower than those in group Q1 and F1 (P lt;0.05).　Conclusion　 The analgesic efficacy of tramadol 2 mg/kg is similar to that of fentanyl 2 μg/kg, but tramadol is more suitable for analgesic treatment in recovery period after general anesthesia due to the higher security.

引用本文： 陳遠豐,呂德生,張大鵬. 曲馬多與芬太尼對全麻蘇醒期鎮(zhèn)痛效果的研究. 華西醫(yī)學, 2010, 25(12): 2234-2236. doi: 復制

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