Vahabi S, Heidari M, Ahmadinejad M, Akhlaghi J, Birjandi M
Anesthesiology Department, Faculty of Medicine, Lorestan University of Medical Sciences, Pardis Educational Institute, Kamalvand Street, Khorram Abad, P.O. Box 13185-1678, Tehran, Iran.
Middle East J Anaesthesiol. 2011 Feb;21(1):9-14.
In this study, the local anesthetic and post-operative analgesic effects of tramadol were compared to those of lidocaine in minor surgeries under local anesthesia.
This double-blind clinical trial study included 70 patients in ASA physical status I and II, aging between 20 and 50 years, undergoing minor surgery (lipoma excision and revision of scars less than 4 cm within 30 minutes or less) under local anesthesia. The patients were randomly assigned to receive either 2 mg/kg tramadol (group T, n = 35) or 1 mg/kg lidocaine 2% (group L, n = 35) subcutaneously. Scores of the pain sensation were recorded as VAS (visual analogue scale 0-10) during injection, incision and 15, 30 and 45 minutes after incision, and then 2, 4 and 6 hours post-operatively at the ward.
There was no significant difference between pain scores of the two groups during injection, incision and surgery or in the post-operative period at the ward (p = 0.181). Incidence of nausea was 0% and 22.8% in group L and group T, respectively. The difference was statistically significant (p = 0.002). Furthermore, 82.9% of subjects in group L and 60% of subjects in group T needed acetaminophen to control their pain and the difference was significant (p = 0.004).
Tramadol 2 mg/kg has local anesthetic and post-operative analgesic effect equal to lidocaine 1 mg/kg in minor surgeries performed subcutaneously. Therefore, we concluded that tramadol can be used as an alternative drug to lidocaine in local anesthesia and has the ability to decrease the demand for post operative analgesics.
在本研究中,比较了曲马多与利多卡因在局部麻醉下小手术中的局部麻醉和术后镇痛效果。
这项双盲临床试验研究纳入了70例ASA身体状况为I级和II级、年龄在20至50岁之间、接受局部麻醉下小手术(脂肪瘤切除以及30分钟以内或更短时间内对小于4厘米的瘢痕进行修复)的患者。患者被随机分配皮下注射2mg/kg曲马多(T组,n = 35)或1mg/kg 2%利多卡因(L组,n = 35)。在注射、切开时以及切开后15、30和45分钟记录疼痛感觉评分,采用视觉模拟评分法(VAS,0 - 10分),然后在病房术后2、4和6小时记录。
两组在注射、切开和手术期间或病房术后的疼痛评分无显著差异(p = 0.181)。L组和T组恶心发生率分别为0%和22.8%。差异具有统计学意义(p = 0.002)。此外,L组82.9%的受试者和T组60%的受试者需要对乙酰氨基酚来控制疼痛,差异显著(p = 0.004)。
在皮下进行的小手术中,2mg/kg曲马多具有与1mg/kg利多卡因相当的局部麻醉和术后镇痛效果。因此,我们得出结论,曲马多可作为局部麻醉中利多卡因的替代药物,并具有减少术后镇痛需求的能力。