Ekemen Serdar, Yelken Birgul, Ilhan Huseyin, Tokar Baran
Department of Anesthesiology, Osmangazi University Medical School, Eskisehir, Turkey.
Pediatr Surg Int. 2008 Jun;24(6):695-8. doi: 10.1007/s00383-008-2147-3. Epub 2008 Apr 12.
Prevention of postoperative pain in children is one of the most important objectives of the anesthesiologist. Opioids have been used as an analgesic for postoperative pain in children for many years. Tramadol has both opioid and monoaminergic agonist actions. The aim of the study was to determine if the analgesic potency and occurrence of adverse effects of tramadol differ from pethidine when administered to children. A total of 110 healthy children, aged 2-12 years, scheduled for elective lower abdominal surgery were randomized to receive either pethidine 1 mg/kg (Group I, n = 60) or tramadol 2 mg/kg (Group II, n = 50) for postoperative pain after anesthesia induction. Pain intensity, adverse effects, heart rate, and systolic and diastolic blood pressure were recorded at regular intervals. The mean pain scores on postoperative 24 h were significantly greater with tramadol than with pethidine. Sedation scores, heart rate and systolic and diastolic blood pressure showed no significant differences between the groups. We conclude that pethidine and tramadol are effective in providing analgesia in pediatric patients, but pethidine provided better postoperative analgesia than tramadol. Changes in blood pressure, heart rate and arterial oxygen saturation were minimal and were similar in both drugs.
预防儿童术后疼痛是麻醉医生最重要的目标之一。多年来，阿片类药物一直被用作儿童术后疼痛的镇痛药。曲马多具有阿片类和单胺能激动剂作用。本研究的目的是确定给儿童使用曲马多时，其镇痛效力和不良反应的发生率与哌替啶相比是否存在差异。共有110名年龄在2至12岁、计划进行择期下腹部手术的健康儿童，在麻醉诱导后随机分为两组，分别接受1 mg/kg哌替啶（I组，n = 60）或2 mg/kg曲马多（II组，n = 50）用于术后镇痛。定期记录疼痛强度、不良反应、心率以及收缩压和舒张压。术后24小时，曲马多组的平均疼痛评分显著高于哌替啶组。两组的镇静评分、心率以及收缩压和舒张压均无显著差异。我们得出结论，哌替啶和曲马多在为儿科患者提供镇痛方面均有效，但哌替啶的术后镇痛效果优于曲马多。两种药物引起的血压、心率和动脉血氧饱和度变化均最小且相似。
