曲马多用于预防全麻患者苏醒躁动临床分析

Clinical Analysis of Tramadol for the Prevention of Anesthesia in Patients with Emergence Agitation

目的:探讨曲马多在全身麻醉拔管时预防患者躁动的临床效果。方法:选择我院2010年1月到2010年6月全麻下行开腹胆囊切除术106例,随机均分为观察组和对照组,行静脉快速诱导,气管插管,术中应用丙泊酚和瑞芬太尼微泵泵入维持,观察组手术结束前关好腹膜后停用维持麻醉药物,静推曲马多2mg/kg,对照组静推生理盐水5mL,术毕送麻醉后恢复室,记录和比较两组患者麻醉复苏时间和术后整体镇静(Remesay评分)评分。结果:观察组意识恢复时间较对照组稍长,呼吸恢复时间和拔管时间与对照组接近,两组患者术后整体镇静观察组Remesay评分烦躁占7.5%,镇静满意占77.4%,镇静过度占15.1%,对照组Remesay评分烦躁占47.2%,镇静满意占39.6%,镇静过度占13.2%,观察组烦躁率明显低于对照组,而对照组镇静满意率明显低于观察组。结论:对于全麻患者,手术结束前静推曲马多2mg/kg,能有效预防患者拔管时的躁动,且应用曲马多后对于患者的苏醒时间无明显影响。

Objective： To investigate the clinical effect of the general anesthesia tramadol extubation in the prevention in patients with restless.Method： Our hospital in January 2010 to June 2010 under general anesthesia of open cholecystectomy 106 cases,randomly divided into observation group and control group,intravenous rapid induction,tracheal intubation,intraoperative propofol and remifentanil infusion micro-pump to maintain the observation group closed before the end of surgery to maintain good retroperitoneal,static push tramadol 2mg/kg,intravenous normal saline control group,5mL,recording and comparing the two groups after anesthesia recovery time and overall sedation（Remesay score） score.Result： Group consciousness recovery time slightly longer than the control group,breathing recovery time and extubation time and close the control group,the overall postoperative sedation score upset,Remesay score of the observation group was 7.5%,sedation was 77.4%,sedation over was 15.1%,the remesay score of observation group irritability was 47.2%,sedation was 39.6%,sedation over was 13.2%.It was significantly lower than the control group,the control group irritability and sedation is significantly lower than the observation group.Conclusion： For patients with general anesthesia,surgery before the end of static push tramadol 2mg/kg,can prevent the agitation in patients with extubation,and recovery time for patients with no significant effect after tramadol.