酒石酸布托啡诺、盐酸曲马多及昂丹司琼注射剂体外配伍稳定性考察

目的:考察酒石酸布托啡诺注射液、盐酸曲马多注射液及盐酸昂丹司琼注射液在0.9%氯化钠注射液中的配伍稳定性。方法:采用HPLC法测定配伍液中三种药物含量,考察三种药物在0.9%氯化钠注射液中,室温条件下72 h内的含量变化,同时观察与检测外观与pH变化。结果:酒石酸布托啡诺注射液、盐酸曲马多注射液及盐酸昂丹司琼注射液的配伍液在72 h内三种药物含量未见明显变化,配伍液外观澄清,pH值保持稳定。结论:酒石酸布托啡诺、盐酸曲马多及盐酸昂丹司琼在0.9%氯化钠注射液中室温条件下、72 h内保持稳定。     

超前镇痛在小儿整形外科手术中的应用

目的:观察氟比洛芬酯与曲马多超前镇痛用于小儿整形外科术后镇痛效果及安全性。方法:小儿整形外科手术60例,随机分为三组。F组于麻醉诱导前缓慢静脉注射氟比洛芬酯1mg/kg,T组于麻醉诱导前缓慢静脉注射曲马多1.5mg/kg,C组缓慢静脉注射生理盐水2ml。观察术后0、1、4、8、12、24hVAS评分及躁动、恶心呕吐、异常出血、呼吸抑制等不良反应。结果:各时间点VAS评分:F组与T组在手术结束即时比较无明显差异,与C组比较评分较低有明显差异。其余各时间点比较F组低于T组,F组和T组低于C组,有明显差异。不良反应T组恶心呕吐高于F组与C组,有统计学意义,C组术后躁动率较F组与T组高,有统计学意义。结论:氟比洛芬酯与曲马多均能减少苏醒期躁动。氟比洛芬酯在整形外科小儿超前镇痛效果较曲马多好。     

Effects of tramadol on experimental inflammation

We examined the ability of the analgesic drug tramadol to affect the development of inflammation in rats. The acute administration of tramadol significantly reduced the edema and the hyperalgesia induced by yeast injection in the paw. Moreover, in the subcutaneous carrageenin-induced inflammation, tramadol reduced the amount of the exudate, as well as the prostaglandin (PG)E2-like bio- and immuno-activity in the exudate; on the contrary, leukotriene (LT)B4 concentrations in the exudate were not changed. However, tramadol did not affect the ability of macrophages to migrate towards the chemotactic peptide N-formyl-L-methionil-L-leucyl-L-phenylalanine (FMLP). Our results suggest that tramadol is able to inhibit the development of different types of inflammation in the rat without affecting immune mechanisms, and contribute to explain the efficacy of this drug in the treatment of inflammatory pain.     

奈福泮复合曲马多在剖宫产术后镇痛中的平衡应用

目的观察静脉给予奈福泮和/或曲马多在剖宫产手术后镇痛的临床效果及不良反应。方法ASA I~II级120例剖宫产手术病人,随机分为奈福泮组(N组)和曲马多组(T组),每组60例,N组奈福泮20 mg 曲马多500 mg 恩丹西酮4 mg;T组曲马多700 mg 恩丹西酮4 mg,均用生理盐水稀释至100 m l。手术结束前5 m in给予负荷剂量后接镇痛泵,进行持续静脉镇痛(C IA)。分别于术后2、8、12、24、32 h采用视觉模拟评分法(VAS)及Ram say镇静评分法(RSS)对镇痛镇静效果进行评定,统计不良反应发生情况。结果VAS和RSS评分组间比较差异无显著性(P>0.05),但不良反应发生率T组明显高于N组。结论奈福泮与曲马多联合用于剖宫产手术的术后镇痛,虽效果与单独使用曲马多相当,但镇痛期间的不良反应发生率明显降低,二种药物联合应用显得更为安全。     

北京朝阳医院2013年急诊科曲马多临床使用情况分析

目的:了解北京朝阳医院急诊患者使用曲马多的情况及合理性,为临床合理用药提供参考。方法:随机抽取2013年该院急诊科医生开具的包含曲马多的处方597张,采用限定日剂量法(DDD)和药物利用指数(DUI)进行评价与分析,对该院曲马多缓释片和曲马多注射液在急诊中的临床使用进行相关数据分析。结果:在本次随机抽取的该院急诊科医生开具的包含曲马多处方中,该品种主要应用于急性疼痛,曲马多缓释片DUI<1,曲马多注射液DUI<1。结论:该院急诊曲马多使用基本合理,但仍有不足,需加强对医生合理用药的宣传。     

Brain delivery of intranasal in situ gel of nanoparticulated polymeric carriers containing antidepressant drug: behavioral and biochemical assessment

This study was aimed for brain delivery of Tramadol HCl (centrally acting synthetic opioid) following intranasal administration for treatment of depression. Chitosan nanoparticles (NPs) were prepared by ionic gelation method followed by the addition of developed NPs with in the Pluronic and HPMC-based mucoadhesive thermo-reversible gel. Developed formulation optimized based on the various parameters such as particle size, entrapment efficiency, in vitro release study. Depression induction was done by forced swim test and evaluated by various behavioral and biochemical parameters. Furthermore, results showed significantly increased in locomotors activity, body weight as compared to control group. It also showed alteration in biochemical parameters such glutathione level and catalase levels significantly increased other than lipid peroxidation and nitrite level was found to be decreased after intranasal administration of formulation. Thus, intranasal TRM HCl NP-loaded in situ gel was found to be a promising formulation for the treatment of depression.     

妇科手术后病人静脉输注曲马多与硬膜外自控镇痛的效果比较

[目的 ]寻找妇科病人手术镇痛的最佳方法 ,减少妇科手术后病人的并发症。 [方法 ]将妇科开腹手术病人 10 0例 ,随机分为对照组和实验组各 5 0例 ,对照组在硬膜外麻醉手术后带硬膜外穿刺管入病房维持 48h ,实验组手术后给予曲马多静脉输注并维持 2 4h ,并根据病人的疼痛感调节滴数。运用“0～ 10”疼痛量表对病人术后 12h、2 4h、48h进行镇痛效果评估 ,同时记录镇痛后尿潴留、恶心呕吐、呼吸抑制等并发症的发生率。 [结果 ]两组病人术后镇痛效果无统计学意义。但实验组副反应发生率明显少于对照组。 [结论 ]妇科术后病人运用静脉输注曲马多镇痛效果与PCEA法相似 ,但并发症明显减少 ,有利于术后病人的早期康复     

帕瑞昔布钠和曲马多在肛周脓肿术中超前镇痛的效果比较

肛周脓肿是肛肠外科常见病和多发病，手术是主要治疗手段，其手术创面通常较大，间隙较深，术后疼痛常较剧烈，因此短期内常需反复依靠镇痛药缓解疼痛。超前镇痛是指在伤害性刺激作用于机体之前采取一定的措施，防治神经中枢敏化，减少或消除伤害引起的疼痛[1]。目前已越来越多地应用于临床，并显示出较好的术后镇痛效果。本研究对帕瑞昔布钠和盐酸曲马多在肛周脓肿术中超前镇痛的临床疗效和不良反应进行比较，为临床实际问题提供解决方案。     

Effects of chronic tramadol administration on testicular tissue in rats: an experimental study

In a prospective experimental study, the effects of chronic tramadol administration on gonadotrophic and sex hormones, histopathological and morphometrical alterations in rat testicular tissue were investigated in a laboratory setting. Tramadol was given alone to adult male albino rats. Gonadotrophic and serum sex hormone levels were measured and testicular pathological and morphometric changes were observed in treated vs. control group. After 30 days of treatment, tramadol induced a decrease in LH, FSH and testosterone serum levels. Histologically, degenerative changes in the seminiferous tubules were observed. They showed shrinkage, separation of tubular basement membrane, disorganisation and vacuolisation of spermatogenic layers. Morphometric analysis revealed significant decrease in the mean values of the tubular diameter and epithelial height. Ultrastructural abnormalities were detected in all cells of spermatogenic lineage in addition to the appearance of apoptotic cells. Sertoli cell vacuolation, huge lipid droplets and disrupted Sertoli cell junctions were observed. Leydig cells showed euchromatic nuclei and dilated smooth endoplasmic reticulum. In view of these findings, it is concluded that tramadol induces alterations in sex hormonal levels in conjunction with disruption of the normal histological structure of rat testis. This might lead to the risk of male infertility. Therefore, tramadol should be used with caution with appropriate dose monitoring.