曲马多对异氟醚的MAC和循环的影响

The effects of tramadol on the minimum alveolar concentration(MAC) of isoflurane and on the hemodynamics

观察４１例患者应用曲马多后对异氟醚ＭＡＣ的影响及对血液动力学的影响。静滴曲马多２ｍｇ／ｋｇ，在３１～５５岁组和≥５６岁组患者的异氟酸ＭＡＣ值分别为１.０７％和０.９６％，静滴曲马多４ｍｇ／ｋｇ，在这两个年龄组异氟醚ＭＡＣ值分别为０．９８％和０．９０％。和基础值相比，静滴由马多４ｍｇ／ｋｇ后患者心率和血压分别增加 ２３． ５％（Ｐ＜０． ００１）和 ７． ７％（Ｐ＜０． ００１）， １０分钟后 Ⅱ组患者的心率和血压均显著高于Ⅰ组（Ｐ<０．０２和０．００２）。结果表明，曲马多可强化吸入麻醉药，大剂量时还有明显的循环效应。

In 41 unpremeditated ASA adult patients we investigated the effects of tramadol on the minimum alveolar concentration (MAC ) of isoflurane and on the patient's heart rate (HR ) and mean blood pressure (MAP). The MAC was assessed by the 'modified up-and -down method'of Dixon. In pa tients at ages 31 -55 years and years ad ministered with tramadol 2mg/kg,the MAC of isoflurane were 1. 07% and 0. 96%, and with tramadol 4mg/kg, were 0. 98% and 0. 90%. Following injection of tramadol 4mg/kg, the patients'HR and MAP increased by 23. 5% (P < 0. 001 ) and 7. 7 % (P< 0. 001 ) respectively compared with baseline values. At 10 minuts after administration of tramadol, the HR and MAP in patients with 4mg/kg were higher than those with 2mg/mg(P<O. 02 and P<O. 002). The present results indicate that tra madol can potentiate the inhalation anesthetic,and large dose of tramadol has marked effects on hemodynamics.