Salhotra Rashmi, Mohta Medha, Agarwal Deepti, Sethi Ashok K
Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi, India.
J Anaesthesiol Clin Pharmacol. 2016 Oct-Dec;32(4):483-486. doi: 10.4103/0970-9185.173323.
Preservative free tramadol has been used as an adjuvant to intrathecal bupivacaine. However, the effect of the addition of tramadol on intrathecal isobaric ropivacaine has never been studied.
This prospective, randomized, double-blind study was conducted in 50 adult male American Society of Anesthesiologists grade I or II patients, aged 18-60 years, being operated for unilateral femur fractures. An epidural catheter was inserted in L2-L3 interspace and subarachnoid block was given in L3-L4 space. The patients were randomized to receive 0.5 mL normal saline (group R) or 0.5 mL (25 mg) preservative free tramadol (group RT) with 2.5 mL of 0.75% intrathecal ropivacaine. Hemodynamic parameters, sensory level, motor block, sedation and side-effects were recorded. Statistical analysis was done using Student's -test, Chi-square test, Fischer's exact test and repeated measures ANOVA.
The time of sensory block onset was 9.2 ± 4.9 min and 8.6 ± 5.3 min ( = 0.714) in group R and group RT, respectively. The motor block onset was also comparable in both the groups ( = 0.112). The duration of sensory block was 147.2 ± 37.4 min in group R and 160.4 ± 40.9 min in group RT ( = 0.252). The median maximum block height achieved in both the groups was T6 and the time to achieve the maximum block was also comparable statistically ( = 0.301).
The addition of intrathecal tramadol 25 mg to the isobaric ropivacaine does not alter the block characteristics produced by intrathecal ropivacaine alone.
不含防腐剂的曲马多已被用作鞘内布比卡因的辅助药物。然而，添加曲马多对鞘内等比重罗哌卡因的影响尚未得到研究。
本前瞻性、随机、双盲研究纳入了50例年龄在18 - 60岁、美国麻醉医师协会分级为I或II级的成年男性患者，他们因单侧股骨骨折接受手术。在L2 - L3间隙插入硬膜外导管，并在L3 - L4间隙给予蛛网膜下腔阻滞。患者被随机分为两组，分别接受0.5 mL生理盐水（R组）或0.5 mL（25 mg）不含防腐剂的曲马多（RT组）与2.5 mL 0.75%鞘内罗哌卡因。记录血流动力学参数、感觉平面、运动阻滞、镇静情况及副作用。采用学生t检验、卡方检验、费舍尔精确检验和重复测量方差分析进行统计学分析。
R组和RT组感觉阻滞起效时间分别为9.2 ± 4.9分钟和8.6 ± 5.3分钟（P = 0.714）。两组运动阻滞起效情况也相当（P = 0.112）。R组感觉阻滞持续时间为147.2 ± 37.4分钟，RT组为160.4 ± 40.9分钟（P = 0.252）。两组达到的最大阻滞平面中位数均为T6，达到最大阻滞的时间在统计学上也相当（P = 0.301）。
在等比重罗哌卡因中添加25 mg鞘内曲马多不会改变单独鞘内罗哌卡因产生的阻滞特征。
