Nagaoka Etsuko, Minami Kouichiro, Shiga Yohsuke, Uezono Yasuhito, Shiraishi Munehiro, Aoyama Kazuyoshi, Shigematsu Akio
Department of Anesthesiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
Anesth Analg. 2002 Mar;94(3):619-25; table of contents. doi: 10.1097/00000539-200203000-00026.
Tramadol is an analgesic that inhibits norepinephrine (NE) reuptake. Although NE released from renal sympathetic nerves causes renal hypoperfusion, the effects of tramadol on renal hemodynamics have not been well characterized. We investigated the effects of tramadol on renal blood flow (RBF), mean arterial blood pressure (MAP), and heart rate (HR) by using a laser Doppler flowmeter, both in normal anesthetized rats and in rats with experimentally-induced nephritis secondary to anti-Thy 1.1 antibody administration. We also studied the effects of tramadol on serum NE levels. Tramadol increased MAP and decreased HR without changing RBF in normal rats at clinical doses. Serum NE levels increased up to 176% of control after a 2 mg/kg bolus injection of tramadol. Continuously infused, increasing doses of tramadol (0.5-4 mg.kg(-1).h(-1)) did not affect MAP, HR, or RBF. Tramadol also increased MAP and decreased HR without changing RBF in rats with experimentally induced renal insufficiency. These findings suggest that a bolus injection of tramadol does not alter RBF, although it causes a decrease in HR and an increase in MAP and serum NE in both normal rats and in rats with renal insufficiency. These results suggest that tramadol may have little effect on RBF during the postoperative period.
A bolus and continuous injection of tramadol does not alter renal blood flow (RBF) in normal rats. A bolus injection of tramadol has little effect on RBF in rats with experimentally induced renal insufficiency. These results suggest that tramadol would be a safe analgesic for maintaining RBF during the postoperative period.
曲马多是一种抑制去甲肾上腺素（NE）再摄取的镇痛药。尽管肾交感神经释放的NE会导致肾灌注不足，但曲马多对肾血流动力学的影响尚未得到充分表征。我们使用激光多普勒血流仪，在正常麻醉大鼠和实验性诱导抗Thy 1.1抗体所致肾炎的大鼠中，研究了曲马多对肾血流量（RBF）、平均动脉血压（MAP）和心率（HR）的影响。我们还研究了曲马多对血清NE水平的影响。在正常大鼠中，临床剂量的曲马多可升高MAP并降低HR，而不改变RBF。静脉推注2mg/kg曲马多后，血清NE水平升高至对照值的176%。持续输注递增剂量的曲马多（0.5 - 4mg·kg⁻¹·h⁻¹）对MAP、HR或RBF无影响。在实验性诱导肾功能不全的大鼠中，曲马多也可升高MAP并降低HR，而不改变RBF。这些发现表明，静脉推注曲马多虽可导致正常大鼠和肾功能不全大鼠的HR降低、MAP和血清NE升高，但不改变RBF。这些结果提示，曲马多在术后期间对RBF可能影响很小。
静脉推注和持续注射曲马多对正常大鼠的肾血流量（RBF）无影响。静脉推注曲马多对实验性诱导肾功能不全的大鼠的RBF影响很小。这些结果表明，曲马多在术后期间维持RBF方面将是一种安全的镇痛药。
