Shipton E A, Roelofse J A, Blignaut R J
Department of Anesthesiology, Christchurch School of Medicine and Health Sciences, University of Otago, Christchurch, New Zealand.
Anesth Prog. 2003;50(3):121-8.
This article details a double-blind, randomized, placebo-controlled pilot study evaluating the analgesic efficacy and clinical acceptability of intravenous tramadol in patients undergoing surgical removal of an impacted third molar tooth under local anesthesia and intravenous sedation with propofol. Forty-five ASA status 1 dental outpatients were randomly allocated to 2 groups of 22 (group A) and 23 (group B) patients each (n = 45). Group A (T/P) received intravenous tramadol 1.5 mg/kg injected over 2 minutes, followed by a bolus dose of intravenous propofol 0.4 mg/ kg. Maintenance consisted of a continuous infusion of propofol 3 mg/kg/h, with an additional bolus dose of 0.4 mg/kg intravenously 2-3 minutes prior to the infiltration of the local anesthetic solution. Group B (P/P) patients received no tramadol but instead a saline placebo solution and an identical amount of propofol. Overall, in this study, postoperative pain was much better controlled in the group receiving tramadol 1.5 mg/kg intravenously despite there being no significant difference in the dose of propofol administered in both groups. Intravenous tramadol, when given with propofol, did not affect the cardiovascular, respiratory, and sedative effects of propofol. Following tramadol, despite being an opioid, no nausea and vomiting were reported in the early postoperative period, indicating the value of using tramadol with propofol. Thus, this pilot study demonstrated the potential use of intravenous tramadol with propofol in day-case dento-alveolar surgery.
本文详细介绍了一项双盲、随机、安慰剂对照的试点研究，该研究评估了静脉注射曲马多在接受局部麻醉和丙泊酚静脉镇静下进行阻生第三磨牙拔除手术患者中的镇痛效果和临床可接受性。45名美国麻醉医师协会（ASA）分级为1级的牙科门诊患者被随机分为两组，每组分别有22名（A组）和23名（B组）患者（n = 45）。A组（曲马多/安慰剂）先在2分钟内静脉注射1.5 mg/kg曲马多，随后静脉推注0.4 mg/kg丙泊酚。维持剂量为持续输注3 mg/kg/h的丙泊酚，并在局部麻醉溶液浸润前2 - 3分钟静脉追加0.4 mg/kg的推注剂量。B组（安慰剂/安慰剂）患者未接受曲马多，而是接受生理盐水安慰剂溶液和等量的丙泊酚。总体而言，在本研究中，尽管两组丙泊酚给药剂量无显著差异，但静脉注射1.5 mg/kg曲马多的组术后疼痛控制得更好。静脉注射曲马多与丙泊酚合用时，不影响丙泊酚的心血管、呼吸和镇静作用。使用曲马多后，尽管它是一种阿片类药物，但术后早期未报告恶心和呕吐，表明曲马多与丙泊酚合用的价值。因此，这项试点研究证明了静脉注射曲马多与丙泊酚在日间牙槽外科手术中的潜在应用。
