The postoperative analgesic effect of tramadol hydrochloride and ketamine on the patients undergoing remifentanil-based anaesthesia

Objective To study the analgesic effect of tramadol hydrochloride or Ketamine on the patients undergoing laparoscopiccholecystectomy after remifentanil-based anaesthesia. Methods A total number of sixty ASA Ⅰ～Ⅱ adult patients who underwent the operation of laparoscopiccholecystectomy were devided to three groups randomly.Controlled group(Group C,n = 20)、Tramadol group((Group T,n = 20)and ketamine group(Group K,n = 20).Before the end of surgery,the patient of group T was given tramadol hydrochloride 2 mg/kg ,group K was given ketamine 0.5 mg/kg ,and group C was given 2ml 0.9% natural solution.All patients were inducted by using propofol,remifentanil,and rocuronium,and maintained aneasthesia with propofol and remifentanil throughout the operation. In the recovery room,those patients was given tramadol 2mg/kg who felt the moderate pain(VRS score ≥6 ).VRS score,the time of requiring analgesia by patients and adverse drug reactions such as nausea,vomit and diplopia were recorded for 24 hours after surgery.Results There were no significant different in postoperation recovery time,pharyngeal mask withdrew time ,heart rate and blood pressure changes between the three groups (P 0.05). At the time of 1 min、10 min、20 min、0.5 h and 4 h after patients regaining consciousness,the VRS scores of group T and group K were significantly lower than that of group C (P 0.05),the frequency of patients requiring analgesia in Group T and group K were also significantly lower than that in group C (P 0.05),and also Group T were lower than group K (P = 0.01),the adverse drug reaction showed no significant difference except that the incidence of restlessness of group T and K were significantly lower than that in group C (P 0.01). Conclusion As well as ketamine ,tramadol hydrochloride has significant analgesic effect on patients with postoperative hyperalgesia after remifentanil-based anaesthesia.