术前口服曲马多缓释片对老年患者无痛肠镜诊疗术中靶控输注异丙酚复合瑞芬太尼麻醉效果的影响

目的 评价术前口服曲马多缓释片对老年患者无痛肠镜诊疗术中靶控输注异丙酚复合瑞芬太尼麻醉效果的影响.方法 拟行无痛肠镜诊疗术患者60例,年龄≥65岁,ASA分级Ⅰ或Ⅱ级,采用随机数字表法,将患者随机分为2组(n=30):对照组(C组)和曲马多组(T组),T组术前2h口服曲马多缓释片100 mg.两组均采用靶控输注异丙酚复合瑞芬太尼麻醉.于麻醉诱导前、肠镜至回盲瓣、术毕时记录SP、DP、HR、SpO2,记录麻醉诱导时间、诊疗操作时间、苏醒时间、恢复时间、不良事件发生情况及异丙酚和瑞芬太尼用量.结果 两组各时点血液动力学指标、麻醉诱导时间、诊疗操作时间、苏醒时间、恢复时间、不良事件发生率及异丙酚和瑞芬太尼用量比较差异无统计学意义(P＞0.05).结论 术前口服曲马多缓释片100 mg可安全用于老年患者无痛肠镜诊疗术,但不能有效增强靶控输注异丙酚复合瑞芬太尼的麻醉效果.

Effect of oral tramadol controlled release tablets premedication on efficacy of anesthesia with target-controlled infusion of propofol and remifentanil for painless colonoscopy in elderly patients

Objective To evaluate the effect of oral tramadol controlled release tablets premedication on the efficacy of anesthesia with target-controlled infusion (TCI)of propofol and remifentanil for painless colonoscopy in elderly patients.Methods Sixty ASA Ⅰ or Ⅱ patients,aged≥ 65 yr,undergoing painless colonoscopy,were randomly divided into 2 groups ( n =30 each): control group (group C) and tramadol group(group T).In group T tramadol controlled-release tablet 100 mg was administered orally at 2 h before operation.Anesthesia was induced and maintained with TCI of propofol and remifentanil.SP,DP,HR and SpO2 were recorded before induction,at the time to reach the ileocecal valve and at the end of operation.The induction time,duration of operation,emergence time,recovery time,adverse events and the amount of propofol and remifentanil consumed were recorded.Results There was no significant difference in hemodynamics parameters,induction time,duration of operation,emergence time,recovery time,adverse events and the amount of propofol and remifentanil consumed between the two groups (P ＞ 0.05 ).Conclusion Oral tramadol controlled release tablets 100 mg premedication can be safely used in painless colonoscopy in elderly patients,however,tramadol can not enhance the efficacy of anesthesia with TCI of propofol and remifentanil.