Abstract: To assess the analgesic efficacy and safty of intravenous fentanyl and tramadol by combined continuous infusion and patient-controlled analgesia (PCA) compared with those of single-PCA in the treatment of postoperative pain following craniotomy, 120 patients were randomly assigned to four groups: 1) PCA with fetanyl (1μg/mL); 2) continuous infusion of fentanyl 1mL/h (1μg/mL) supplied PCA; 3) tramadol (25 mg/mL); 4) continuous infusion of tramadol 1 mL/h (25 mg/mL) supplied PCA. Continuous infusion was stopped at 24 h after craniotomy. Patient pain intensity score (VAS score 0-10), PCA demanded and delivered times, total dose and side-effects were recorded. The total PCA delivered times, demand times and VAS score in groups receiving single-PCA were significantly more than those in groups receiving continuous infusion suppling PCA (P<0.05). When comparing two groups receiving a combined regimen of continuous infusion and PCA, we found that the total PCA delivered times, demand times and total dose in fentanyl group were significantly higher than tramadol group (P<0.05). The patients'VAS score had no significant difference between two groups. Fentanyl and tramadol are efficient and safe for pain control after craniotomy. The regimen of combination of PCA and background infusion is more efficient without increasing the incidence of opioid side effects.

Key words: PCA( patient controlled anagesia), pain, fentanyl, tramadol, craniotomy