曲马多超前镇痛用于小儿腭裂修补术的临床观察

目的观察小儿腭裂修补术中曲马多超前镇痛的有效性和安全性。方法选择46例美国麻醉医师协会分级法（ASA）Ⅰ—Ⅱ级腭裂修补术患儿，年龄1～3岁，随机分为曲马多组和对照组，全麻诱导气管插管后在术前分别静推曲马多2mg/kg和相同容量的生理盐水。记录患儿围麻醉期间血流动力学变化，并测定苏醒期的躁动评分，观察有无恶心呕吐、呼吸抑制、反流误吸等不良反应。结果两组患儿围麻醉期间术中血流动力学平稳，组间差异无显著性；但曲马多组在拔管时和苏醒期血流动力学明显较对照组平稳。苏醒期躁动评分曲马多组满意率明显高于对照组（P〈0．05）。两组患儿均未发生恶心呕吐、呼吸抑制、反流误吸等不良反应。结论小儿腭裂修补术术前静推曲马多2mg/kg可获得围麻醉期间较为平稳的血流动力学，减少拔管期的躁动，且不增加术后呼吸抑制、恶心呕吐等不良反应的发生率。

The preeptive analgesia of tramadol used in cleft palate repairment of child

Objective To explore the validity and security of the preeptive analgesia of tramadol used in cleft palate repairment of little child. Methods Forty - six patients, performed with cleft palate repairment, ASA （ Ⅰ-Ⅱ） ,agedl -3 years old, were randomly divided into two groups：T group{using tramadol} and C group（ without tramadol）. After tracheal intubation, all patients were randomly transfused with tramadol （2mg/kg） or isovolume NS.The hemodynmnics changes of the ambanesthetic stage and the restlessness score of the palinesthesia stage were recorded, also we observed the adverse reactions like nausea and vomiting, breath inhibition, regurgitation and aspiration. Results The homodynamic changes of two groups in the anrbanesthetic stage were stable, the interclass difference was of no significance ; but The changes of the T group were obviously more stable in the extubation period and palinesthesia stage than the C group. And also for the satisfactory ratio of the restlessness score in the palinesthesia stage , T group was higher than C group（ P 〈 0.05）. Our study observed no adverse reactions. Conclusion With tramadol （2mg/kg） injected intravenously before the cleft palate repairment, little child gained relative stableness of circulation systems, less restlessness in the extubation, no increasing incidence rate of the postoperative adverse reactions such as , breath inhibition, regurgitation and aspiration.