曲马多预防老年患者全身麻醉手术后拔管反应的临床观察

目的:观察曲马多预防老年患者全身麻醉手术后拔管反应的临床疗效。方法:选择择期在全身麻醉下行胃大部切除或胆囊切除手术老年患者60例,随机分为2组,各30例。曲马多组静脉注射曲马多2mg·kg-(1氯化钠注射液稀释至5mL),2min注完,3min后停用维持麻醉药物,对照组则静脉注射氯化钠注射液。观察比较2组患者围术期血流动力学改变(平均动脉压(MAP)、心率(HR))及拔管前、后血氧饱和度(SpO2)变化及拔管后的不良反应。结果:术毕,2组MAP、HR、SpO2差异无统计学意义(P>0.05);拔管即刻、拔管后5、15min,曲马多组的MAP、HR明显低于对照组(P<0.05);曲马多组在拔管即刻SpO2显著高于对照组(P<0.05);对照组HR、MAP在拔管即刻和拔管后5、15min明显高于术毕(P<0.05);曲马多组HR、MAP在术毕和拔管后5、15min明显优于对照组,2组比较差异有统计学意义(P<0.05);对照组拔管后呛咳12例,躁动11例,寒战10例,切口疼痛21例;曲马多组拔管后呛咳1例,躁动2例,寒战0例,切口疼痛6例,2组比较差异有统计学意义(P<0.05)。结论:全身麻醉手术的老年患者麻醉苏醒期应用曲马多可预防术后拔管反应。

Prevention Effect of Tramadol on Reaction of Tracheal Extubation in Elderly Patients Undergoing General Anesthesia Operation

OBJECTIVE：To investigate the prevention effect of tramadol on reaction of tracheal extubation in elderly patients undergoing general anesthesia operation.METHODS：60 patients undergoing upper abdomen operation were randomly divided into 2 groups.Tramadol group was intravenously injected with 2 mg·kg-1 tramadol（diluted with Sodium chloride injection to 5 mL） within 2 min.Anaesthetic was discontinued after 3 min.Control group were injected with Sodium chloride injection.The changes of Perioperative hemodynamics（MAP,HR）,SpO2 before and after tracheal extubation and side effects after tracheal extubation were observed in 2 groups.RESULTS：At the instant of operation,there were no significant difference in MAP,HR and SpO2 between 2 groups（P0.05）;MAP and HR in tramadol group were lower than in control group at the instant of extubation,at 5 min after extubation and 15 min after extubation（P0.05）;SpO2 at the instant of extubation in tramadol group was higher than in control group（P0.05）;HR and MAP of control group at the instant of extubation,at 5 min after extubation and 15 min after extubation were higher than that at the end of operation（P0.05）;HR and MAP of tramadol group after operation,at 5 min after extubation and 15 min after extubation were superior to that of control group,there were statistical significance（P0.05）;After extubation results of control group showed 12 cases of cough,11 cases of restlessness,10 cases of shivering and 12 cases of incision pain.After extubation results of tramadol group showed 1 case of cough,2 cases of restlessness,none of shivering and 6 cases of incision pain.There were statistical significance in difference between 2 groups（P0.05）.CONCLUSION：Tramadol can the prevent effect of tramadol on reaction of tracheal extubation in patients with general anesthesia operation.