Ozcengiz D, Gunduz M, Ozbek H, Isik G
Department of Anaesthesiology, Faculty of Medicine, Cukurova University, 01330 Balcal 1, Adana, Turkey.
Paediatr Anaesth. 2001 Jul;11(4):459-64. doi: 10.1046/j.1460-9592.2001.00694.x.
We compared the quality and duration of analgesia, the effect on perioperative sevoflurane requirement after a single, presurgical caudal block with either tramadol or morphine in children undergoing inguinal herniorrhaphy. Our study was also designed to evaluate the preemptive analgesic efficacy of morphine administered caudally in children.
Patients were randomly divided into three groups to receive 2 mg.kg-1 tramadol (group T, preemptive group) or morphine sulphate 0.03 mg.kg-1 (group M, preemptive group). The patients in control group (group C, postincisional group) received morphine sulphate 0.03 mg.kg-1 at the end of surgery, caudally. Cardiorespiratory data, sedation and pain were recorded for 24 h following recovery from anaesthesia.
There were no differences between the three groups in baseline blood pressure or heart rate; or duration of anaesthesia, surgery. The inhaled sevoflurane concentration was significantly lower in group M and group T than in the control group. The quality and duration of postoperative pain relief did not differ between the three groups. There were no intergroup differences in postoperative nausea, vomiting, or other complications.
Caudal tramadol (2 mg.kg-1) provided reliable postoperative analgesia similar to caudal morphine (0.03 mg.kg-1) in quality and duration of pain relief in our study children who were undergoing herniorrhaphy. We also concluded that presurgical caudal morphine or tramadol reduced perioperative sevoflurane requirements and either presurgical or postsurgical caudal morphine did not make any difference to postoperative analgesia.
我们比较了曲马多或吗啡单次术前骶管阻滞对接受腹股沟疝修补术儿童镇痛的质量和持续时间，以及对围手术期七氟醚需求量的影响。我们的研究还旨在评估骶管注射吗啡对儿童的超前镇痛效果。
患者被随机分为三组，分别接受2mg·kg-1曲马多（T组，超前镇痛组）或0.03mg·kg-1硫酸吗啡（M组，超前镇痛组）。对照组（C组，切口后给药组）患者在手术结束时接受0.03mg·kg-1硫酸吗啡骶管注射。记录麻醉苏醒后24小时的心肺数据、镇静和疼痛情况。
三组患者的基线血压、心率、麻醉时间和手术时间无差异。M组和T组吸入七氟醚浓度显著低于对照组。三组术后疼痛缓解的质量和持续时间无差异。术后恶心、呕吐或其他并发症在组间无差异。
在我们的研究中，对于接受疝修补术的儿童，骶管注射曲马多（2mg·kg-1）在疼痛缓解质量和持续时间上提供了与骶管注射吗啡（0.03mg·kg-1）相似的可靠术后镇痛效果。我们还得出结论，术前骶管注射吗啡或曲马多可降低围手术期七氟醚需求量，且术前或术后骶管注射吗啡对术后镇痛无差异。
