曲马多、氯诺昔康防治全麻苏醒期躁动

Tramadol or lornoxicam reduces restlessness during recovery after general anesthesia

目的 观察曲马多、氯诺昔康治疗全麻苏醒期躁动的疗效。方法 选择 6 0例全麻病人 ,双盲随机分为 3组 ,术毕缝皮前静脉用药 ,Ⅰ组为曲马多 3mg/kg ,Ⅱ组氯诺昔康 16mg ,Ⅲ组注射用水 2ml。观察指标为躁动评分、Ramsay镇静评分、BCS舒适评分、心率、平均压、恶心呕吐。观察时间点为 :麻醉前 (t1)、用药后 30min(t2 )和 4 0min(t3)、气管拔管时 (t4 )、拔管后 5min(t5 )和 10min(t6 )。结果 气管拔管时心率、平均压Ⅰ组比Ⅲ组低 (P <0 .0 5 ) ;用药后 30min、拔管后 5min ,Ⅰ组与Ⅱ组、Ⅲ组相比 ,镇静有显著差异 (P <0 .0 5 ) ;用药后 4 0min、气管拔管时、拔管后 10min ,Ⅰ组与Ⅲ组相比 ,躁动显著减少 (P <0 .0 5 ) ;用药后 4 0min、拔管后 10min ,Ⅱ组、Ⅲ组相比 ,躁动显著减少 (P <0 .0 5 ) ;Ⅰ组、Ⅱ组比Ⅲ组舒适 (P <0 .0 5 )。结论 曲马多、氯诺昔康可防治全麻苏醒期躁动 ,曲马多更有效。

Objective:To observe the effect of tramadol or lo rnoxicam on treating the restlessness during recovery after general anesthesia. Methods:The randomized,double blind study was conducted in 60 p atients who received general anesthesia. All patients were divided into three gr oups: group Ⅰ (n=20) received tramadol 3 mg/kg,group Ⅱ (n=20) received lorno xicam 16 mg,group Ⅲ(n=20) received normal saline 2 ml intravenously. Trama dol,lornoxicam or normal saline was administered before the skin closed. The level of restlessness,sedation and comfort were evaluated at 6 intervals: pre- induction,30 min and 40 min after intravenous adm inistration of the drug,im mediately after tracheal extubation,5 min and 10 min afer tracheal extubation,HR and MAP were moritored at the same time.Results: HR and MAP were lower in group Ⅰ than that in group Ⅲ immediately after tracheal extuba tion( P <0.05). Sedation scores were significant difference in group Ⅰ than that in group Ⅱ or in group Ⅲ( P <0.05).Restlessness scores were lower in group Ⅰ than that in group Ⅲ at 40 min after intravenous administration of th e drug,immediately after tracheal extubation and at 10 min. After tracheal ex tubation( P <0.05);restlessness scores were lower in groupⅡ than that in gro up Ⅲ at 40 min after intravenous administration of the drug and at 10 min afte r tracheal extubation( P <0.05). Patients in group Ⅰ or in group Ⅱ were mo re comfortable than those in group Ⅲ(P(0.05).Conclusions: Tramadot or lornoxi cam Can reduce restlessness during recovery after general an esthesia,and tramadol is better.