Clinical Observation of the Postoperative Hyperalgesia of Patients Induced by Tramadol Inhibiting Remifentanil

Objective:To observe the influence of tramadol on postoperative hyperalgesia induced by remifentanil.Methods:Sixty patients(ASA gradeⅠ to Ⅱ) undergone upper abdominal selective operation were randomly divided into three groups(n=20) to be treated by the total intravenous anesthesia of remifentanil,propofol and intermittent intravenous Cis-atracurium.Before 15 min of finishing the operation,the patients in group A and B were given intravenous tramadol(1 mg/kg to the group A,2 mg/kg to the group B) respectively and the patients in the control group C were given fentanyl 1μg/kg to record the recovery time,extubation time,hemodynamics index of patients at extubation,VAS scores after extubation,Ramsay scores and the time of requiring analgesia from extubation,the status of adverse reactions of nausea and vomiting and respiratory inhibition after extubation of the patients in recovery room in each group.Results:There was no statistical significance of hemodynamics index at extubation comparing between the three groups(P0.05).The time of recovery and extubation was longest in the group C.The VAS scores after recovery were highest in the group A and lower in the group B and C(P0.05).There was no statistical significance comparing between the group B and C(P0.05).There was no statistical significance comparing Ramsay scores in three groups(P0.05).The incidence of respiratory inhibition happened highest in the group C and the incidence of nausea and vomiting in the group B and C occurred higher than those in the group A.Conclusion:It could safely and effectively reduce the hyperalgesia after remifentanil anesthesia to do intravenous injection of 2 mg/kg tramadol before 15 min of the operation for the operative patients.