摘要
目的观察曲马多预防神经外科瑞芬太尼麻醉术后痛觉过敏的效果。方法 100例择期神经外科幕上肿瘤切除手术患者,随机分为曲马多组和对照组,每组50例。采用静吸复合麻醉,麻醉维持采用瑞芬太尼0.1～0.2μg·kg-1·min-1和丙泊酚泵注,吸入七氟醚。于缝皮前静脉给予1.5mg/kg曲马多或生理盐水。记录两组患者拔管和苏醒时间及要求镇痛的例数、曲马多用量和不良事件。分别于苏醒后15min、30min、60min和120min行疼痛视觉模拟(VAS)评分、Ramsay镇静评分。结果两组患者拔管和苏醒时间比较差异无统计学意义(P>0.05);曲马多组要求镇痛例数(8/50vs.25/50)、曲马多用量(28.3mgvs.51.1mg)和寒战例数(3/50vs.12/50)低于对照组(P<0.05);15min、30minVAS评分对照组高于曲马多组(P<0.05);两组患者各时点Ramsay评分无统计学差异。结论曲马多可以有效预防开颅手术瑞芬太尼麻醉后的痛觉过敏,亦不增加不良反应的发生。
Objective To evaluate the preventive effects of tramadol on the patients with postoperative hyperalgesia after remifentanil-based neurosurgical anaesthesia. Methods 100 patients undergoing craniotomy were randomly assigned to two groups:tramadol group and normal saline group.Anesthesia was maintained with remifentanil (at 0.1-0.2 μg·kg-1·min-1) in combination with propofol and sevoflurane.Tramadol was given before skin closing for inhibiting remifentanil-induced postoperative hyperalgesia.The emergence time,trachea extubation time,patients required analgesia,the tramadol consumption and adverse effects were compared.VAS and Ramsay scores were also recorded at 15,30,60 and 120 min after emergency. Results There were no significant difference in trachea extubation time and emergence time among the two groups. Compared with normal saline group,patients required analgesia(8/50 vs.25/50),tramadol consumption(28.3 mg vs.51.1 mg) and incidence of shivering were significantly lower than those in tramadol group (P<0.05).Pain VAS scores in normal saline group were significantly higher than those in tramadol group at 15 and 30 min after emergency (P<0.05).There were no significant difference in the Ramsay scores between two groups(P>0.05). Conclusions Tramadol can effectively prevent postoperative hyperalgesia after remifentanil-based neurosurgical anaesthesia without increasing the incidence of adverse effects.
出处
《中华临床医师杂志（电子版）》
CAS
2011年第19期5666-5669,共4页
Chinese Journal of Clinicians(Electronic Edition)
关键词
曲马朵
哌啶类
痛觉过敏
神经外科手术
Tramadol
Piperidines
Hyperalgesia
Neurosurgerical procedures
