頁籤選單縮合
題 名 | Prospective and Randomized Trial of Intravenous Tenoxicam Versus Fentanyl and Tramadol for Analgesia in Outpatient Extracorporeal Lithotripsy=門診體外震波碎石術中經靜脈隨機給予Tenoxicam, Fentanyl或Tramadol止痛效果的比較 |
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作 者 | 賈元一; 劉康; | 書刊名 | 麻醉學雜誌 |
卷 期 | 36:1 1998.03[民87.03] |
頁 次 | 頁17-22 |
分類號 | 418.224 |
關鍵詞 | 止痛劑非固醇類消炎藥:tenoxicam; 嗎啡類藥品:fentanyl tramadol HCl; 碎石術:體外震波碎石術; Analgesics anti-inflammatory agents non-steroidal:tenoxicam; Analgesics opioid:fentanyl tramadol HCl; Lithotripsy:extracorporeal shock wave lithotripsy; ESWL; |
語 文 | 英文(English) |
中文摘要 | 背景:因為體外震波碎石術常常應用于門診患者,因此,選擇一種可依賴及副 作用小的止痛劑是很重要的。本實驗主要在評估三種不同的作用機轉的藥物,其於門診患者 體外震波碎石術止痛效果及副作用的不同。 方法:我們選擇 120 位欲接受體外震波碎石術的門診患者,隨機分成三組,分別接受 靜脈給予 fentany11 μ g/kg,tramadol HC11.5mg/kg 或 tenoxicam 0.3mg/kg, 並在不同 的震波強度詢問患者口述疼痛指標,倘若患者疼痛數值高於 4 或患者無法忍受此疼痛,則 我們就給予補充劑量的止痛劑 fentany125 μg,直到適當止痛效果達到為止。我們也同 時記錄其相關副作用。 結果:三組在年紀,身高,體重,ASA 分類,疼痛指數,震波總數,接受 fentany1 補 充劑量的人數,平均劑量,及頭昏副作用方面均無不同,但是,在 fentany1 及 tramadol 組則有較高比例噁心或嘔吐副作用產生,而且 fentany1 組有較高比例產生動脈血氧飽和濃 度下降的情形。另外,震波強度疼痛指數有正相關性。 結論:本實驗結果顯示三種不同作用機轉的藥物均可提供體外震波碎石術的門診患者一 個很好的止痛,但是因為 tenoxicam 不具嗎啡類藥物的副作用,似乎更可提供一個好的麻 醉品質。另外,在手術中依患者需要及震波強度的提高再給予補充劑量的止痛劑似乎也是一 恰當作法。 |
英文摘要 | Backgrornd: As extracorporeal shock wave lithotripsy (ESWL) is frequently carried out on an outpatient basis, it is crucial to choose an adequate analgesic with less adverse effect. This study evaluated the use of three different intravenous agents: fentany, tramadol HCl and tenoxicam in ESWL. Methods: One hundred and twenty patients undergoing lithotripsy were randomly assigned to receive either intravenous fentany11 μ g/kg, tramadol HCI 1.5mg/kg or tenoxicam 0.3 mg/kg before lithotripsy. Pain intensity was recorded using verbal rating pain scales (VRPS). Cases without adequate analgesia (VRPS>4) or could not tolerate the pain, additional bolus of fentany125 μ g were given until adequate analgesia was achieved. Side effects were recorded as well. Results: No significant differences were found among groups in demographic data, VRPS, number of total shock waves, cases with supplementary fentanyl, mean dose of supplementary fentany1 or the incidence of dizziness. However, the incidence of nausea or vomiting was significantly higher in fentany1 and tramadol groups comparing with tenoxicam group (15.0% and 25.0% vs,0.0%). Oxygen saturation in fentany1 group was also significantly lower than the other two groups (p<0.01). In addition, VRPS had a significant correlation with voltage intensities (p<0.05). Conclusions: Lithotripsy can be satisfactorily performed by employing fentany1, tramadol or tenoxicam for analgesia; tenoxicam apparently offers a better analgesic quality with less side effect. Furthermore, the need for stronger analgesia during larger voltage intensity should be tailored to the needs of the individuals. |
本系統中英文摘要資訊取自各篇刊載內容。