曲马多减轻全麻患者拔管期间心血管反应的临床观察

目的: 观察全麻患者拔管前静脉注射曲马多对拔管期间心血管反应的抑制效应,探讨其临床使用价值。方法: 40例择期手术患者,随机分为观察组和对照组,每组20例。术毕前30 min停用麻醉药物,观察组静脉注射曲马多1.5 mg/kg,对照组不用药。观察用药时、吸痰时、拔管时瞬间、拔管后1 min、5 min的收缩压(SBP)、舒张压(DBP)、心率(HR)。结果: 对照组吸痰、拔管瞬间、拔管后1 minSBP、DBP、HR均较用药时明显增高(P<0.01),拔管后5 min稍下降,但SBP仍高于用药时(P<0.05),而观察组SBP、DBP、HR在上述各期稳中略有升高,但与用药时差异均无显著性(P>0.05),两组间各数值比较差异均有显著性(P<0.05~P<0.001)。观察组患者苏醒平稳,无躁动,无切口疼痛。结论: 曲马多能有效减缓全麻术毕拔管期间的心血管副反应。

Effect of tramadol in reducing the cardiovascular response during tracheal extubation in patients receiving general anesthesia

Objective:To observe the cardiovascular response during extubation in patients who have received general anesthesia by vein injection of tramadol.Methods:Forty patients were randomly divided into observation group and control group,with 20 patients in each.Use of anesthesia was halted half hour before the completion of operation,then tramadol 1.5 mg/kg was administered intravenously to the patients in the observation group,but no medicine was given to the control group.The SBP,DBP,HR at the moment of injection,the time of phlegm sucking,the moment of extubation and 1 minute and 5 minutes after extubation were observed.Results:The SBP,DBP and HR increased significantly at the moment of phlegm sucking,extubation,and 1 minute after extubation in the control group,compared with those at the moment of injection(P<0.01).And The SBP,DBP and HR decreased slightly at 5 minutes after extubation;however the SBP was still higher than that at the moment of injection(P<0.05).In the observation group,the SBP,DBP,HR were stable and increased slightly during the above mentioned moments,and their difference with the moment of injection was not significant(P>0.05).The patients come back stably,with no mania or pain on the wound.Conclusions:Tramadol can effectively relieve the cardiovascular response at extubation for patients receiving general anesthesia.