目的：评价利多卡因联合曲马多超前镇痛的有效性和安全性。方法：将于全凭静脉麻醉下行腹腔镜胆囊切除术的90例患者随机分为T1组、T2组和C组，每组30例。于术前、术毕，T1组静脉注射曲马多100 mg ，T2组静脉注射利多卡因50 mg和曲马多50 mg混合液，C组注射0．9％氯化钠液作为对照。比较3组患者的术后苏醒时间、镇静/醒觉（OAA/S）评分、术后疼痛视觉模拟评分法（VAS ）评分、不良反应等。结果：3组患者术后苏醒时间差异无统计学意义，T1组术后15 min时OAA/S评分高于另外两组（P＜0．05），术后30 min、1 h时3组OAA/S评分差异无统计学意义；T1、T2组术后0．5、1、2、4、6、12 h时VAS评分低于C组（P＜0．05），24 h时3组VAS评分差异无统计学意义；T2组拔管时心率、血压较T1、C组平稳。结论：利多卡因联合曲马多超前镇痛效果明确、不良反应少、麻醉恢复平稳，镇痛效果优于单用曲马多。%Objective:To analyze the effect and security of lidocaine combined with tramadol for preemptive analgesia .Meth-ods:A totle of 90 patients undergoing laparoscopic cholangiotectomy under total infusion venus anesthesia (TIVA) were divided into Group T1 ,Group T2 and Group C ,with 30 patients in each group .Before and after the operation ,the patients in Group T1 received intravenous tramadol 100 mg ;the patients in Group T2 received intravenous lidocaine 50 mg and tramadol 50 mg ;the patients in Group C received saline injection .The awakening time ,alertness/sedation (OAA/S) scale ,visual analoue scale (VAS) ,and the untoward effects of patients after operation among the 3 groups were compared .Results:The postoperative a-wakening time of patients in 3 groups had no statistical difference ,and the OAA/S score at postoperative15 min in Group T1was higher than those in Group T2 and Group C (P<0 .05) .The VAS scores at 0 .5、1、2 、4、6、12 h after the operation in Group T1 and Group T2 were lower than those in Group C (P<0 .05) ,but those in Group T1 and Group T2 had no statistical diffe-rences .The blood pressure and heart rate of patients in Group T 2 were more stable than those in Group T1 and Group C .Con-clusions:Lidocaine combined with tramadol intravenously injected shows definite preemptive analgesia effects and stable anes-thesia recovery ,and it is better than tramadol alone .
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