摘要：目的：探讨关腹前曲马多对上腹部术后患者早期恢复质量及并发症的影响。方法：42例上腹部择期手术患者(ASAⅠ～Ⅱ)随机均分为两组：T组(曲马多组)和C组(对照组)。T组于关腹前静脉给予曲马多(2mg/kg)，C组给等量生理盐水。手术结束后患者在恢复室滞留90min，观察患者恢复质量(睁眼时间、拔管时间、定向力恢复时间、最大VAS评分、需要追加镇痛药患者例数)及并发症(恶心、呕吐、嗜睡、高血压、心动过速、呼吸抑制)。结果：两组患者术后呼名睁眼时间、拔管时间及定向力恢复时间差异无显著性(P>0.05)；但T组的最大VAS评分远低于C组(P<0.05)，观察期间需要追加阿片类镇痛药者例数也明显少于C组(P<0.05)。两组患者术后恶心、呕吐、高血压、心动过速、呼吸抑制等并发症的发生率差异无显著性(P>0.05)。结论：关腹前曲马多(2mg/kg)有助于提高患者术后早期恢复质量而不增加并发症。

    关键词：曲马多；全身麻醉；恢复质量

    Wound Closure Tramadol Administration Improves Quality of Recovery without Increasing side Effects in the early Stage after Upper Abdominal Operation

    QU LI-zhe,et al

    (Shanghai TCM Hospital, Shanghai 200071, China)

    Abstract：Objective: To evaluate the effects of tramadol administration at wound closure on recovery quality in patients undergoing upper abdominal surgery. Methods: 42 ASA I～II patients were allocated into two groups (n=20 in each) to receive either tramadol 2mg/kg (group T) or placebo saline (group C) iv at the time of wound closure. All patients stayed in recovery room for 90min before returning the ward , during this period, the times to eye opening, orientation, and tracheal extubation, as well as maximal pain score by VAS were observed; and the incidence of side effects including nausea/vomiting, tachycardia, hypertension, tachypnea, drowsiness and respiratory depression were also noted. Results: No statistically significant difference was found between the two groups in respect to the times to eye opening, orientation, and tracheal extubation (P>0.05), but the maximal VAS score was markedly lower in group T than that in group C (P<0.01), and 5 patients in group T and 11 in group C required additional dose of analgesic to relieve pain in recovery room (P<0.01). The side effects were similar between the two groups. Conclusion: Wound closure tramadol (2mg/kg) administration improves analgesic effect without increasing side effects in the early stage after upper abdominal surgery. ......