Effects of tramadol on the patients with postoperative hyperalgesia induced by remifentanil-based neurosurgical anaesthesia

Objective To evaluate the preventive effects of tramadol on the patients with postoperative hyperalgesia after remifentanil-based neurosurgical anaesthesia. Methods 100 patients undergoing craniotomy were randomly assigned to two groups:tramadol group and normal saline group.Anesthesia was maintained with remifentanil (at 0.1-0.2 μg·kg-1·min-1) in combination with propofol and sevoflurane.Tramadol was given before skin closing for inhibiting remifentanil-induced postoperative hyperalgesia.The emergence time,trachea extubation time,patients required analgesia,the tramadol consumption and adverse effects were compared.VAS and Ramsay scores were also recorded at 15,30,60 and 120 min after emergency. Results There were no significant difference in trachea extubation time and emergence time among the two groups. Compared with normal saline group,patients required analgesia(8/50 vs.25/50),tramadol consumption(28.3 mg vs.51.1 mg) and incidence of shivering were significantly lower than those in tramadol group (P0.05).Pain VAS scores in normal saline group were significantly higher than those in tramadol group at 15 and 30 min after emergency (P0.05).There were no significant difference in the Ramsay scores between two groups(P0.05). Conclusions Tramadol can effectively prevent postoperative hyperalgesia after remifentanil-based neurosurgical anaesthesia without increasing the incidence of adverse effects.