Altunkaya H, Ozer Y, Kargi E, Babuccu O
Department of Anesthesiology, Zonguldak Karaelmas University, School of Medicine, Kozlu/Zonguldak, Turkey.
Br J Anaesth. 2003 Mar;90(3):320-2. doi: 10.1093/bja/aeg079.
Recent studies have shown that a local anaesthetic action of tramadol 5% was able to induce a sensory block to pinprick, touch, and cold similar to that of lidocaine 1%. The aim of this study was to compare the local anaesthetic effects of tramadol hydrochloride with prilocaine.
Sixty ASA I or II patients, undergoing excision of the cutaneous lesions under local anaesthesia, were included in the study. Patients were randomly assigned to receive either 1 ml of tramadol 5% (Group T, n=30) or 1 ml of prilocaine 2% (Group P, n=30) intradermally, in a double-blinded fashion. The degree of the burning sensation and pain at the injection site was documented. Sensory block was assessed 1 min after injection. The patient was asked to report the degree of sensation and to grade touch and pinprick sensation. Two minutes after drug administration, incision was performed and intensity of pain, felt by the patient was evaluated on a four-point scale (0-3). Any local adverse effects were recorded.
There was no difference in the quality of block between the two groups. Side effects were noted in both groups with a significant increase in the incidence of local reaction (rash) in Group T (seven patients) when compared with Group P (one patient) (P<0.05). Seven patients in Group T vs four patients in Group P complained of burning at the injection site (P>0.05).
Intradermal tramadol 5% can provide a local anaesthesia similar to the prilocaine but the incidence of local adverse effects is higher.
近期研究表明,5%曲马多的局部麻醉作用能够诱导与1%利多卡因相似的对针刺、触觉和冷觉的感觉阻滞。本研究的目的是比较盐酸曲马多与丙胺卡因的局部麻醉效果。
本研究纳入了60例在局部麻醉下接受皮肤病变切除术的美国麻醉医师协会(ASA)I或II级患者。患者被随机双盲分配,皮内注射1 ml 5%曲马多(T组,n = 30)或1 ml 2%丙胺卡因(P组,n = 30)。记录注射部位的烧灼感和疼痛程度。注射后1分钟评估感觉阻滞情况。要求患者报告感觉程度并对触觉和针刺感觉进行分级。给药两分钟后进行切口,并采用四点量表(0 - 3)评估患者感觉到的疼痛强度。记录任何局部不良反应。
两组之间的阻滞质量没有差异。两组均观察到副作用,与P组(1例患者)相比,T组(7例患者)局部反应(皮疹)的发生率显著增加(P < 0.05)。T组7例患者与P组4例患者主诉注射部位有烧灼感(P > 0.05)。
皮内注射5%曲马多可提供与丙胺卡因相似的局部麻醉,但局部不良反应的发生率更高。