Lee Seok-Jin, Choi Seok Jun, In Chi Bum, Sung Tae-Yun
Department of Anaesthesiology and Pain Medicine, Konyang University Hospital.
Department of Anaesthesiology and Pain Medicine, Konyang University Hospital, Myunggok Medical Research Center, Konyang University College of Medicine, Daejeon, Korea.
Medicine (Baltimore). 2019 Mar;98(10):e14763. doi: 10.1097/MD.0000000000014763.
Emergence agitation (EA) is common after nasal surgery. Strong opioids and N-methyl-D-aspartate (NMDA) receptor antagonists prevent EA. Tramadol also acts as an opioid receptor agonist and an NMDA receptor antagonist, but few studies have evaluated the effects of tramadol on EA. This retrospective study investigated whether tramadol is effective for reducing EA in adult patients undergoing nasal surgery.Of 210 adult patients undergoing a nasal surgical procedure under general anesthesia, the medical records of 113 were analyzed retrospectively. The patients were divided into 2 groups: patients who received tramadol during the operation (tramadol group, n = 52) and patients who did not (control group, n = 61). The incidence of EA, recovery time, changes in hemodynamic parameters, postoperative pain scores, and adverse events were compared between the 2 groups.The incidence of EA was higher in the control group than in the tramadol group (50.8% [31/61] vs 26.9% [14/52]; odds ratio 2.805; 95% confidence interval, 1.3 to 6.2; P = .010). Changes in systolic blood pressure in the 2 groups were similar, whereas changes in heart rate during emergence differed depending on the group (P = .020), although pairwise comparisons did not reveal any differences between the groups. Recovery time, postoperative pain scores, and adverse events were similar in the 2 groups.In adult patients undergoing nasal surgery, tramadol infusion decreases the incidence of EA after sevoflurane anesthesia without delaying recovery or increasing the number of adverse events.
术后躁动（EA）在鼻部手术后很常见。强效阿片类药物和N-甲基-D-天冬氨酸（NMDA）受体拮抗剂可预防EA。曲马多也可作为阿片受体激动剂和NMDA受体拮抗剂，但很少有研究评估曲马多对EA的影响。这项回顾性研究调查了曲马多在接受鼻部手术的成年患者中减少EA是否有效。在210例接受全身麻醉下鼻部手术的成年患者中，对113例患者的病历进行了回顾性分析。患者分为两组：术中接受曲马多的患者（曲马多组，n = 52）和未接受曲马多的患者（对照组，n = 61）。比较两组之间的EA发生率、恢复时间、血流动力学参数变化、术后疼痛评分和不良事件。对照组的EA发生率高于曲马多组（50.8% [31/61] 对26.9% [14/52]；优势比2.805；95%置信区间，1.3至6.2；P = 0.010）。两组收缩压的变化相似，而苏醒期间心率的变化因组而异（P = 0.020），尽管两两比较未显示两组之间有任何差异。两组的恢复时间、术后疼痛评分和不良事件相似。在接受鼻部手术的成年患者中，输注曲马多可降低七氟醚麻醉后EA的发生率，且不延迟恢复或增加不良事件的数量。
