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扁桃体切除术前扁桃体周注射曲马多和肾上腺素的效果。

Effects of Peritonsillar Injection of Tramadol and Adrenaline before Tonsillectomy.

作者信息

Beigh Zafarullah, Ul Islam Mudasir, Ahmad Shakil, Ahmad Pampori Rafiq

机构信息

Department of Otorhinolaryngology. Govt. Medical College Srinagar J&K India. Srinagar. India.

出版信息

Iran J Otorhinolaryngol. 2013 Jun;25(72):135-40.

PMID:24303433
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3846232/
Abstract

INTRODUCTION

Various hemostatic and analgesic agents and techniques have been used to reduce intraoperative and postoperative hemorrhage and pain in tonsillectomy.Aims and objective; The current study aimed to compare the effect of using adrenaline plus tramadol and normal saline in maintaining hemostasis and control of pain in cold dissection tonsillectomy.

MATERIALS AND METHODS

This prospective randomized study was conducted over a period of 10 months in department of otorhinolaryngology state medical college Srinagar. In the current study 46 patients planed for tonsillectomy were put into two groups. 23 patients in each group. In group A patients (study group) 4ml of solution containing 1:200000 adrenaline and 2mg/kg tramadol was injected in peritonsillar space. In group B patients (control group) 4ml of normal saline was injected in peritonsillar space.

RESULTS

It was found that the time required to achieve heamostasis and post operative pain was less in group A patients in comparison to Group B patients. There was no significant side effect or complications when adrenaline and tramadol were used.

CONCLUSION

Large randomized controlled studies are needed to compare tramadol plus adrenaline infiltration with other heamostatic and analgesics, but the current study indicated that Tramadol plus adrenaline infiltration could be an effective method to reduce the post operative pain , operative time and time to achieve heamostasis in tonsillectomy surgeries. Therefore the use of Tramadol plus adrenaline infiltration should be further promoted and implemented as routine use in tonsillectomy surgeries.

摘要

引言

各种止血和镇痛药物及技术已被用于减少扁桃体切除术中及术后的出血和疼痛。目的:本研究旨在比较肾上腺素加曲马多与生理盐水在冷剥离扁桃体切除术中维持止血和控制疼痛的效果。

材料与方法

这项前瞻性随机研究在斯利那加政府医学院耳鼻喉科进行了10个月。在本研究中,46例计划行扁桃体切除术的患者被分为两组,每组23例。A组患者(研究组)在扁桃体周围间隙注射4毫升含1:200000肾上腺素和2毫克/千克曲马多的溶液。B组患者(对照组)在扁桃体周围间隙注射4毫升生理盐水。

结果

发现A组患者实现止血和术后疼痛所需的时间比B组患者少。使用肾上腺素和曲马多时没有明显的副作用或并发症。

结论

需要进行大型随机对照研究来比较曲马多加肾上腺素浸润与其他止血和镇痛药物,但目前的研究表明,曲马多加肾上腺素浸润可能是减少扁桃体切除手术术后疼痛、手术时间和止血时间的有效方法。因此,曲马多加肾上腺素浸润的使用应进一步推广并作为扁桃体切除手术的常规用法实施。

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本文引用的文献

1
Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy.曲马多局部用药在控制扁桃体切除术后儿童术后疼痛中的镇痛效果。
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Comparison of intravenous and peritonsillar infiltration of tramadol for postoperative pain relief in children following adenotonsillectomy.曲马多静脉注射与扁桃体周浸润用于儿童腺样体扁桃体切除术后疼痛缓解的比较
Eur J Anaesthesiol. 2009 Apr;26(4):333-7. doi: 10.1097/EJA.0b013e32831c8988.
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Effects of intramuscular and peritonsillar injection of tramadol before tonsillectomy: a double blind, randomized, placebo-controlled clinical trial.扁桃体切除术前肌内注射和扁桃体周注射曲马多的效果:一项双盲、随机、安慰剂对照临床试验
Int J Pediatr Otorhinolaryngol. 2008 Feb;72(2):241-8. doi: 10.1016/j.ijporl.2007.11.002.
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Peritonsillar infiltration with tramadol improves pediatric tonsillectomy pain.曲马多扁桃体周围浸润可减轻小儿扁桃体切除术后疼痛。
Eur Arch Otorhinolaryngol. 2008 May;265(5):571-4. doi: 10.1007/s00405-007-0479-6. Epub 2007 Oct 17.
6
Local bupivacaine-epinephrine infiltration combined with general anesthesia for adult tonsillectomy.局部布比卡因-肾上腺素浸润联合全身麻醉用于成人扁桃体切除术。
Acta Otolaryngol. 2005 Sep;125(9):972-5. doi: 10.1080/00016480510043413.
7
Pre-incisional infiltration for pediatric tonsillectomy: a randomized double-blind clinical trial.小儿扁桃体切除术前切口浸润:一项随机双盲临床试验
Int J Pediatr Otorhinolaryngol. 2005 Oct;69(10):1333-41. doi: 10.1016/j.ijporl.2005.03.020. Epub 2005 Apr 22.
8
The postoperative analgesic effect of tramadol when used as subcutaneous local anesthetic.曲马多用作皮下局部麻醉剂时的术后镇痛效果。
Anesth Analg. 2004 Nov;99(5):1461-1464. doi: 10.1213/01.ANE.0000135640.21229.A0.
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The effects of intrathecal tramadol on spinal somatosensory-evoked potentials and motor-evoked responses in rats.鞘内注射曲马多对大鼠脊髓体感诱发电位和运动诱发电反应的影响。
Anesth Analg. 2003 Mar;96(3):783-788. doi: 10.1213/01.ANE.0000049683.58980.30.
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Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures.曲马多与丙胺卡因用于小手术的局部麻醉效果比较。
Br J Anaesth. 2003 Mar;90(3):320-2. doi: 10.1093/bja/aeg079.