Cl inical Study of Patient Controlled Analgesia with Intravenous Fentanyl and Tramadol and Epidural Morphine af ter Radical Mastectomy of Breast Cancer

Objective 　To compare the pain relief efficacy and complication of Fentanyl and Tramadol int ra2 venous PCA( PCIA) with morphine epidural PCA ( PCEA) . Methods 　One hundred and eighteen Ameri2 can Society of Ananesthetist SA Ⅰ～ Ⅳpatient s ages 35～70 years scheduled for radical mastectomy were divided randomlyinto three groups : Group F ( n = 60) PCIA2Fentanyl 1. 0 mg + Midazolam 10 mg + azas2 t ron 10 mg + 0. 9 % N. S to 100 ml ; Group T ( n = 60) PCIA2Tramadol 1000 mg + Droperidol 5 mg +0. 9 % N. S to 100 ml ; Group M ( n = 60) PCEA2Morphine 1 mg + Droperidol 5 mg + Bupivacaine 150 mg + 0. 9 % N. S to 100 ml. PCA (Automen 2300 bung of Korea) was commenced to the end of agery and continucd for 48 h, PCA settings was : bolus dose of 0. 5 ml, background infusion of 2 ml/ h, lockout time of 15 min. The following parameters were recorded : dosage of drugs, VAS, SS, patient' s satisfactions and complications. Results 　Fentanyl (1. 0 ±0) mg, press key (8 ±1. 5) ; Tramadol (908. 2 ±59. 7) mg, press key (6. 0 ±1. 5) ; morphine (5. 0 ±0) mg, press key 0. There was no significant difference between PCIA and PCEA in VAS, SS and patient satisfaction rate ( > 97 %) . The rate of nausea and vomiting in group F and T was significantly lower than that of group M ( P < 0. 05), group M tickle 25 %, nausea and vomiting 28 %. There was no significant difference among three groups in respiratory and circulation ( P > 0. 05) . Conclusion 　PCIA with fentanyl and t ramadol is better than PCEA with morphine, which might be lower in the rate of complications .