Kesimci E, Izdes S, Gozdemir M, Kanbak O
Ataturk Training and Research Hospital, Ankara, Turkey.
Acta Anaesthesiol Scand. 2007 Jul;51(6):736-41. doi: 10.1111/j.1399-6576.2007.01308.x. Epub 2007 Apr 10.
The aim of this prospective, randomized, double-blind study was to evaluate the effect of the addition of tramadol to ropivacaine on the onset and duration of sensory and motor block, and duration of analgesia, for axillary brachial plexus block.
After institutional approval and informed consent had been obtained, 45 patients scheduled for forearm or hand surgery under axillary brachial plexus block were randomly allocated into two groups. The ropivacaine group received 40 ml of ropivacaine 7.5 mg/ml plus 2 ml of isotonic sodium chloride solution, and the tramadol group received 40 ml of ropivacaine 7.5 mg/ml plus 2 ml (100 mg) of tramadol. The onset and duration of sensory and motor block in the distribution of the musculocutaneous, radial, median and ulnar nerves, the duration of analgesia, the time to first pain medication, hemodynamics and side-effects were recorded.
The addition of tramadol did not improve the speed of onset or increase the duration of sensory and motor block. The durations of analgesia were 631 +/- 33 min and 633 +/- 37 min (mean +/- standard deviation) in the ropivacaine and tramadol groups, respectively (P > 0.05). Hemodynamic parameters and side-effects did not differ between the groups.
The addition of 100 mg of tramadol to 7.5 mg/ml of ropivacaine, for axillary brachial plexus block, does not prolong the duration of motor and sensory block and analgesia.
这项前瞻性、随机、双盲研究的目的是评估在腋路臂丛神经阻滞中,将曲马多添加到罗哌卡因中对感觉和运动阻滞的起效时间和持续时间以及镇痛持续时间的影响。
在获得机构批准并取得知情同意后,将45例计划在腋路臂丛神经阻滞下进行前臂或手部手术的患者随机分为两组。罗哌卡因组接受40 ml 7.5 mg/ml的罗哌卡因加2 ml等渗氯化钠溶液,曲马多组接受40 ml 7.5 mg/ml的罗哌卡因加2 ml(100 mg)曲马多。记录肌皮神经、桡神经、正中神经和尺神经分布区域的感觉和运动阻滞的起效时间和持续时间、镇痛持续时间、首次使用止痛药物的时间、血流动力学和副作用。
添加曲马多并未改善起效速度,也未增加感觉和运动阻滞的持续时间。罗哌卡因组和曲马多组的镇痛持续时间分别为631±33分钟和633±37分钟(平均值±标准差)(P>0.05)。两组之间的血流动力学参数和副作用没有差异。
在腋路臂丛神经阻滞中,在7.5 mg/ml的罗哌卡因中添加100 mg曲马多,不会延长运动和感觉阻滞及镇痛的持续时间。