Degala Saikrishna, Nehal Asad
Department of Oral and Maxillofacial Surgery, J.S.S. Dental College & Hospital (Constituent College), Jagadguru Sri Shivarathreeshwara University, 570015, Mysuru, Karnataka, India.
Oral Maxillofac Surg. 2018 Sep;22(3):275-280. doi: 10.1007/s10006-018-0700-3. Epub 2018 May 29.
The aim of this study was to assess the better postoperative analgesic, tramadol, and ketorolac, in patients with maxillofacial trauma and who had undergone maxillofacial surgery, i.e., open reduction internal fixation, under general anesthesia.
After taking ethical approval from the institution and informed consent, 46 ASA grade I-II patients were block randomized (ABAB) based on inclusion and exclusion criteria and equally divided into two groups in which one group of patients was given intravenous tramadol 100 mg and another group of patients was given intravenous ketorolac 30 mg at the time of closure of skin and was repeated after 8 and 16 h following surgery. Pain using VAS at the 2nd, 4th, 6th, 12th, and 24th postoperative was assessed, and association of results was compared using Cramer's V test SPSS (Version 22). Vital signs and side effects were recorded.
Although both drugs resulted in significant decrease in pain intensity from the 2nd to 24th postoperative hour, intravenous tramadol always resulted in better pain control than intravenous ketorolac at every postoperative hour (p value < 0.05) except at 2nd hour where changes are non-significant (p value > 0.05).
Apart from first 2 h where the changes are non-significant, this study clearly demonstrates the advantage of the intravenous tramadol in the management of postoperative pain and ease of administration in postoperative patient through IV cannula. The side effects of both the drugs were insignificant and did not have any effect on the result.
本研究旨在评估在全身麻醉下接受颌面外科手术(即切开复位内固定术)的颌面创伤患者中,曲马多和酮咯酸这两种术后镇痛效果更好的药物。
在获得机构伦理批准并取得知情同意后,根据纳入和排除标准对46例美国麻醉医师协会(ASA)I-II级患者进行区组随机分组(ABAB),并平均分为两组,一组患者在皮肤缝合时静脉注射100mg曲马多,另一组患者在皮肤缝合时静脉注射30mg酮咯酸,并在术后8小时和16小时重复给药。评估术后第2、4、6、12和24小时使用视觉模拟评分法(VAS)的疼痛情况,并使用SPSS(版本22)的克莱默V检验比较结果的关联性。记录生命体征和副作用。
尽管两种药物均使术后第2小时至24小时的疼痛强度显著降低,但除第2小时变化不显著(p值>0.05)外,静脉注射曲马多在每个术后小时的疼痛控制效果均优于静脉注射酮咯酸(p值<0.05)。
除前2小时变化不显著外,本研究清楚地证明了静脉注射曲马多在术后疼痛管理中的优势,以及通过静脉留置针在术后患者中给药的便利性。两种药物的副作用均不显著,且对结果没有任何影响。