Ko Byoung-Woo, Shim Jae-Hang, Lee Byung-Ro, Cho Hee-Yoon
Department of Ophthalmology, Hanyang University College of Medicine, Seoul, Korea.
Korean J Ophthalmol. 2009 Dec;23(4):273-6. doi: 10.3341/kjo.2009.23.4.273. Epub 2009 Dec 4.
To evaluate the effectiveness of tramadol for the reduction of pain in panretinal photocoagulation (PRP).
A double-masked randomized controlled study was performed. Fifty-eight eyes in 29 patients with proliferative diabetic retinopathy were enrolled. The eyes of the patients were randomized into two groups. Group A received an empty capsule. Group B received an oral intake of 100 mg tramadol. The capsule used in Group A had the same appearance as that used in Group B. Pain during PRP was assessed using a visual analog scale. Vital signs, including blood pressure and heart rate, were measured.
The mean pain scores for groups A and B were 4.80+/-2.10 and 3.83+/-1.82 (p=0.09). There were no significant differences in the mean pain scores between the two groups. More patients in group A complained of greater pain than moderate intensity (visual analogue scale=4). Systemic blood pressure increased significantly in group A after laser treatment. However, there were no significant differences in the diastolic blood pressure changes between the two groups. We found no statistical correlation in the heart rate changes.
We failed to prove that tramadol is effective for pain relief because of the small sample size. However, tramadol was effective for the relief of more severe pain. It was also found to stabilize vital sign changes, such as systolic blood pressure during PRP.
评估曲马多在全视网膜光凝(PRP)中减轻疼痛的有效性。
进行了一项双盲随机对照研究。纳入29例增殖性糖尿病视网膜病变患者的58只眼。将患者的眼睛随机分为两组。A组服用空胶囊。B组口服100mg曲马多。A组使用的胶囊外观与B组相同。使用视觉模拟量表评估PRP期间的疼痛。测量包括血压和心率在内的生命体征。
A组和B组的平均疼痛评分分别为4.80±2.10和3.83±1.82(p = 0.09)。两组之间的平均疼痛评分无显著差异。A组中更多患者抱怨疼痛程度大于中度(视觉模拟量表=4)。激光治疗后A组的全身血压显著升高。然而,两组之间舒张压变化无显著差异。我们发现心率变化无统计学相关性。
由于样本量小,我们未能证明曲马多对缓解疼痛有效。然而,曲马多对缓解更严重的疼痛有效。还发现它能稳定生命体征变化,如PRP期间的收缩压。