【摘要】 目的 比较硬膜外曲马多和氟哌利多超前镇痛与术后镇痛的临床效果和安全性。方法 选择ASA Ⅰ～Ⅱ级，年龄36～52岁，择期在硬膜外麻醉下行妇科手术的患者36例，随机分为超前镇痛组(Ⅰ组)和术后镇痛组(Ⅱ组)，每组18例。Ⅰ组在术前20min经硬膜外导管一次性注入曲马多100mg和氟哌利多2mg；Ⅱ组在术毕即硬膜外注入上述等量药物。术后2、4、8、12、24h随访并记录镇痛效果、镇静程度及不良反应，监测血压、心率、呼吸频率；术中记录局麻药用量。结果 超前镇痛组术后8～24h镇痛效果优于术后镇痛组，且局麻药用量减少。结论 硬膜外曲马多和氟哌利多超前镇痛效果优于术后镇痛。

    【关键词】 超前镇痛；硬膜外；曲马多；氟哌利多

    Preemptive epidural tramadol with droperidol for postoperative pain relief in gynecological surgical patients

    LUO Zheng-yong.Department of Anesthesiology, The People’s Hospital of Qianan Autonomous Prefecture for Buyi and Miao Nationalities,Guizhou 558000,China

    【Abstract】 Objective To compare the efficacy and safety of tramadol and droperidol for preemptive analgesia with traditional postoperative pain-relief. Methods 36ASA physical status Ⅰ～Ⅱ patients scheduled for selective gynecological procedures were randomly assigned to two groups: pre-emptive analgesia group(group Ⅰ, n=18)and postoperative analgesia group(group Ⅱ, n=18). In group I, single bolus of tramadol 100mg and droperidol 2mg in normal saline was injected epiduraly 20 minutes before local anesthetic administration. In group Ⅱ, the same dose of drugs as in group I was given immediately at the end of surgery. The patients were followed up at 2,4,8,12,24h after operation. The side effects, heart rate, blood pressure, and respiratory rate were recorded. Results The amount of anesthetics in the group Ⅰ was significantly lower than that in group Ⅱ(P<0.05). Sedation scores of two groups were not different. Blood pressure, heart rate, and respiratory rate in two groups remained un-changed.Conclusion Preemptive epidural tramadol 100mg with droperidol 2mg has a better analgesic effect than postoperative pain relief with same drugs. ......