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采用硬膜外病人自控镇痛（PCEA）技术，对不同配伍曲马多术后镇痛效应进行研究。将90例（ASAⅠ～Ⅱ级）手术病例随机分成三组，Ⅰ组（n＝30）用1％曲马多；Ⅱ组（n=30）用1％曲马多＋0．125％布比卡因；Ⅲ组（n=30）用1％曲马多＋0．25％布比卡因；采用双盲法对比观察。结果术后24小时三组病人VAS评级Ⅰ组＞Ⅱ组＞Ⅲ组（P＜0．05）；三组曲马多用量Ⅰ组＞Ⅱ组＞Ⅲ组（P＜0．05）；PCEA总按数／实进数（D／D）比值在0～2范围内的病例数，Ⅲ组＞Ⅱ组＞Ⅰ组（P＜0．05），提示Ⅱ、Ⅲ组镇痛效果较单纯组好。三组病人PCEA期间呼吸、循环无明显变化，无肢体运动障碍；恶心、呕吐等并发症较低。结论：选择曲马多行PCEA镇痛时，复合0．25％的布比卡因其镇痛效果更好。
The epidural patient-controlled analgesia (PCEA) technique was used to study the analgesic effect of tramadol with different compatibility. Ninety cases (ASA gradeⅠ ~ Ⅱ) were randomly divided into three groups: Ⅰ (n = 30) with 1% tramadol; Ⅱ (n = 30) with 1% tramadol plus 0.125% The patients in group Ⅲ (n = 30) were treated with 1% tramadol and 0.25% bupivacaine, and compared by double-blind method. Results The VAS scores of the three groups at 24 hours postoperatively were as follows: group Ⅰ> group Ⅱ> group Ⅲ (P <0.05); group 3, group Ⅰ, group Ⅱ> group Ⅲ (P <0.05) (D / D) ratio in the range of 0 to 2, and group Ⅲ> group Ⅱ> group Ⅰ (P <0.05), suggesting that the analgesic effects in group Ⅱ and group Ⅲ were better than those in group Ⅱ. PCEA during the three groups of breathing, no significant changes in circulation, no limb movement disorders; nausea, vomiting and other complications lower. CONCLUSIONS: The analgesic effect of 0.25% bupivacaine is better when tramadol is used for analgesia in multiple rows.