Pang W W, Mok M S, Chang D P, Huang M H
Department of Anesthesia, Show-Chwan Memorial Hospital, Changhua, Taiwan, ROC.
Reg Anesth Pain Med. 1998 Nov-Dec;23(6):580-3. doi: 10.1016/s1098-7339(98)90085-2.
We observed clinically that tramadol and metoclopramide appear to have local anesthetic action. Tramadol is a central-acting analgesic. Metoclopramide is a commonly used antiemetic. The local anesthetic effect of tramadol in reducing propofol injection pain has never been mentioned, although it was speculated with metoclopramide.
We conducted a double-blind, placebo-controlled study by injecting tramadol or metoclopramide intradermally in 10 healthy volunteers (5 men, 5 women; age 25-56 years). Each subject received 0.5 mL of four solutions in random order on the volar side of the forearm. These solutions were 25 mg tramadol, 5 mg metoclopramide, 5 mg lidocaine, and 0.5 mL normal saline. Pain on injections and the degree of local anesthesia (tested by pinprick, light touch, and cold) at each site was reported on a 0-3 scale at designed time intervals.
Like 1% lidocaine, tramadol and metoclopramide demonstrated loss of sensation for pinprick, light touch, and cold for 15 minutes after intradermal injection (P < .01 ).
Intradermal tramadol or metoclopramide can produce local anesthetic effect.
我们在临床上观察到曲马多和甲氧氯普胺似乎具有局部麻醉作用。曲马多是一种中枢性镇痛药。甲氧氯普胺是一种常用的止吐药。尽管曾有人推测曲马多可减轻丙泊酚注射痛，但曲马多的局部麻醉作用从未被提及。
我们对10名健康志愿者（5名男性，5名女性；年龄25 - 56岁）进行了一项双盲、安慰剂对照研究，在前臂掌侧皮内注射曲马多或甲氧氯普胺。每位受试者按随机顺序在前臂掌侧接受0.5 mL的四种溶液注射。这些溶液分别为25 mg曲马多、5 mg甲氧氯普胺、5 mg利多卡因和0.5 mL生理盐水。在设定的时间间隔内，受试者需按照0 - 3分的量表报告每次注射时的疼痛程度以及每个部位的局部麻醉程度（通过针刺、轻触和冷觉测试）。
与1%利多卡因一样，曲马多和甲氧氯普胺皮内注射后15分钟内对针刺、轻触和冷觉均表现出感觉丧失（P < 0.01）。
皮内注射曲马多或甲氧氯普胺可产生局部麻醉作用。
