曲马多联合 0.5%左旋布比卡因用于单次肌间沟臂丛阻滞：对肩关节置换术后患者术后镇痛的影响。

Tramadol and 0.5% levobupivacaine for single-shot interscalene block: effects on postoperative analgesia in patients undergoing shoulder arthroplasty.

机构信息

Department of Anesthesia and Pain Therapy, Ospedale San Camillo, Brescia, Italy.

出版信息

Minerva Anestesiol. 2012 Mar;78(3):291-6.

PMID:21971437

Abstract

BACKGROUND

The aim of this study was to evaluate the efficacy of tramadol as an adjuvant to the local anaesthetic solution in patients undergoing shoulder arthroscopy for rotator cuff tear after middle interscalene block (MIB).

METHODS

We enrolled 120 patients (ASA I-II), scheduled for arthroscopic surgery for rotator cuff tear. The patients were sedated with midazolam 0.02 mg/kg and haloperidol 2 mg i.v. before performing MIB. All subjects underwent a MIB with 0.4 mL/kg of 0.5% levobupivacaine. After computerized randomization, all patients were allocated in 1 of 3 groups, each including 40 subjects. Group Placebo (Group P) received 0.4 mL/kg of 0.5% levobupivacaine plus isotonic sodium chloride for MIB and isotonic sodium chloride i.m. Group "Perineural Tramadol" (Group TPN) received 0.4 ml/Kg of 0.5% levobupivacaine plus 1.5 mg/kg of tramadol perineurally and isotonic sodium chloride i.m. Group "Intramuscular Tramadol" (Group TIM) received 0.4 ml/Kg of 0.5% levobupivacaine plus isotonic sodium chloride perineurally and 1.5 mg/kg of tramadol i.m.

RESULTS

The MIB onset times were not statistically different in the three groups. The duration of analgesia was significantly longer in Groups TPN and TIM, where tramadol was administered, either i.m. or perineurally, compared with the placebo group. A significant statistical difference was found in the duration of analgesia between the group TPN and TIM.

CONCLUSION

The addition of tramadol to the local anaesthetic solution administered for MIB provided a longer duration of analgesia compared with placebo and i.m tramadol administration in patients undergoing arthroscopic surgery for rotator cuff tear.

摘要

背景

本研究旨在评估曲马多作为肩袖撕裂患者行肌间沟阻滞（MIB）后行肩关节镜检查时局部麻醉溶液的辅助药物的疗效。

方法

我们纳入了 120 名接受肩袖撕裂关节镜手术的患者（ASA I-II 级）。在进行 MIB 前，患者静脉注射咪达唑仑 0.02mg/kg 和氟哌啶醇 2mg 进行镇静。所有患者均接受 0.4mL/kg 的 0.5%左旋布比卡因的 MIB。通过计算机随机化后，所有患者被分配到 3 组中的 1 组，每组 40 例。对照组（P 组）接受 0.4ml/kg 的 0.5%左旋布比卡因加 MIB 中的等渗生理盐水和等渗生理盐水肌内注射。“神经周围曲马多”组（TPN 组）接受 0.4ml/Kg 的 0.5%左旋布比卡因加 1.5mg/kg 的曲马多神经周围注射和等渗生理盐水肌内注射。“肌肉内曲马多”组（TIM 组）接受 0.4ml/Kg 的 0.5%左旋布比卡因加等渗生理盐水神经周围注射和 1.5mg/kg 的曲马多肌内注射。