静脉注射曲马多对瑞芬太尼全麻苏醒期不良反应及术后不适的预防作用

Clinical effects of tramadol in the prevention of adverse reactions and postoperative discomfort during awakening period of general anesthesia with remifentenyl

目的观察静注曲马多抑制瑞芬太尼全麻术后苏醒期不良反应的情况。方法将80例全麻择期手术患者分为观察组与对照组各40例,两组均以咪唑安定、维库溴铵、瑞芬太尼诱导,维库溴铵异丙酚瑞芬太尼异氟醚维持麻醉,观察组于手术结束前30分钟给予曲马多1 mg/kg静脉注射,记录两组患者苏醒期心血管反应和躁动程度,对术后早期切口疼痛和咽喉疼痛程度评分。结果苏醒期心血管反应发生率对照组为62.5%,观察组为20%,差异有统计学意义(P<0.01),躁动程度观察组较对照组明显减轻(P<0.01),术后早期切口疼痛程度发生率中、重度疼痛Ⅰ组轻于Ⅱ组,组间比较差异有统计学意义(P<0.01),术后咽喉疼痛程度Ⅰ组轻于Ⅱ组(P<0.01)。结论瑞芬太尼全麻结束前预注曲马多可有效减轻苏醒期不良反应和术后早期的疼痛。

Objective To investigate the preventive effect of pre-injecting tramadol on the adverse reactions and postoperative discomfort in general anesthesia with remifentenyl during awakening period.Methods 80 cases undergoing general surgery were randomly divided into observation group(groupⅠn=40)and control group(groupⅡn=40)respectively.30 min before the end of operation,GroupⅠwas given tramadol 1 mg/kg,The cardiovascular response,the degree of restlessness in the awakening period,the early incision pain and throat score after the operation were evaluated.Results The incidence of cardiovascular response during awakening period in the group Ⅰwas 20%,which significantly lower than groupⅡ(62.5%)(P < 0.01).The degree of restlessness,the early incision pain and throat score after the operation were mild in group Ⅰ,the difference between the two groups had statistically significance(P<0.01).Conclusion The pre-injecting tramadol can prevent effectively the adverse reactions and postoperative pains in general anesthesia awakening period.