Demiraran Yavuz, Ilce Zekeriya, Kocaman Buket, Bozkurt Pervin
Department of Anesthesiology, School of Medicine, Abant Izzet Baysal University, Konuralp/Duzce, Turkey.
Paediatr Anaesth. 2006 Oct;16(10):1047-50. doi: 10.1111/j.1460-9592.2006.01910.x.
It has been demonstrated that tramadol is an effective analgesic. We aimed to compare postoperative analgesic effects of wound infiltration with tramadol (T) or bupivacaine (B) and intramuscular tramadol (I) after herniotomy in children.
In this study, 75 children were randomly assigned to group T, group B and group I. Wound infiltration was performed to the patients in group T (2 mg.kg-1 tramadol in 0.2 ml.kg-1 saline) and group B (0.2 ml.kg-1 0.25% bupivacaine) into the surgical incision. Twenty minutes before the end of the surgery 2 mg.kg-1 tramadol was injected i.m. in group I. Faces pain scale was used for assessing pain severity. Patients with pain score>2 were treated with paracetamol. The frequency of side effects and analgesic use were recorded. Patients were discharged on the next day.
No side effects were recorded in any group. The pain scores of the patients at the first, fourth and eighth hours were significantly higher in group B and group I than group T (P<0.05). The pain scores of the patients at the first hour were significantly higher in group I compared with group B (P<0.05). Average time to first analgesic requirement was significantly longer in group T (6.72+/-4.09 h after herniotomy than both group I (4.49+/-3.9 h) and group B (6.04+/-3.7 h) (P<0.05).
Wound infiltration with tramadol may be a good choice for postoperative analgesia in children having inguinal herniotomy.
已证明曲马多是一种有效的镇痛药。我们旨在比较儿童疝修补术后曲马多（T）或布比卡因（B）伤口浸润与肌内注射曲马多（I）的术后镇痛效果。
在本研究中，75名儿童被随机分为T组、B组和I组。对T组（2mg·kg-1曲马多加入0.2ml·kg-1生理盐水中）和B组（0.2ml·kg-1 0.25%布比卡因）的患者进行手术切口处的伤口浸润。在手术结束前20分钟，I组肌内注射2mg·kg-1曲马多。采用面部疼痛量表评估疼痛严重程度。疼痛评分>2的患者用对乙酰氨基酚治疗。记录副作用和镇痛药物使用的频率。患者于次日出院。
任何组均未记录到副作用。B组和I组患者在第1、4和8小时的疼痛评分显著高于T组（P<0.05）。I组患者在第1小时的疼痛评分显著高于B组（P<0.05）。T组首次需要镇痛的平均时间（疝修补术后6.72±4.09小时）显著长于I组（4.49±3.9小时）和B组（6.04±3.7小时）（P<0.05）。
曲马多伤口浸润可能是小儿腹股沟疝修补术后镇痛的一个良好选择。
