Beigh Zafarullah, Ul Islam Mudasir, Ahmad Shakil, Ahmad Pampori Rafiq
Department of Otorhinolaryngology. Govt. Medical College Srinagar J&K India. Srinagar. India.
Iran J Otorhinolaryngol. 2013 Jun;25(72):135-40.
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.
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.
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.
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.
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。
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。
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。
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。