The Effects of Tramadol versus Fentanyl in Attenuating Hemodynamic Response following Tracheal Intubation

Tramadol和Fentanyl對於減少氣管插管所引起血液動力反應作用比較

龐維伍(Wei-Wu Pang) ； 雷志宏(Chih-Hung Lei) ； 張大鵬(Da-Peng Chang) ； 童健瓊(Chien-Chiung Tung) ； 黃明和(Min-Ho Huang)

《Acta Anaesthesiologica Sinica》 37卷4期 (1999/12) Pp. 191-196

https://doi.org/10.6955/AAS.199912.0191

摘要

Background: Tramadol is a novel central acting analgesic. It has been used as a complement to general anesthesia and an effective agent for postoperative analgesia. However, the influence of tramadol on the hemodynamic response following laryngoscopy and tracheal intubation is less known.
Methods: Forty patients of both sexes, 16-50 year old, ASA physicalstatus I or II, scheduled for elective surgery were randomly divided into equal groups in this prospective, double blind study. After obtaining the baseline data, the patient was given 3 µg/kg fentanyl (Group F) or 3 mg/kg tramadol (Group T). Then induction of anesthesia in a uniform and standardized manner was carried out by an anesthesiologist who was blind to the medication. The hemodynamic parameters were measured and recorded immediately after induction but prior to laryngoscopy, 3, 6, and 9 min after intubation, and before incision. We also observed any unusual effect in the postoperative care unit. Chi-square test, Student’s t-test and paired t-test were used for statistical comparison. A P less than 0.05 was considered statistically significant.
Results: All patients had a successful induction and intubation. Differences in baseline values were not significant, nor were the differences in the values following induction. After laryngoscopy and intubation, heart rate increased significantly above the baseline level in both groups. The increase of heart rate was significantly more at 6 and 9 mm (P＜0.05) and lasted longer in the tramadol group. After intubation, systolic, mean and diastolic arterial pressure (SAP, MAP, DAP) increased significantly above baseline in both groups too, except for DAP in fentanyl group. At 6 and 9 mm, the MAP and DAP were significantly higher in tramadol than in fentanyl group (P＜0.05). Six patients in tramadol group had mild pain on injection of tramadol.
Conclusions: When administered right before thiopental induction, 3 mg/kg tramadol did not display a better attenuation against the increase of hemodynamic profiles than did 3 µg/kg fentanyl following tracheal intubation.

關鍵字

Tramadol ； 術後：疼痛 ； 血流動力學

並列摘要

Background: Tramadol is a novel central acting analgesic. It has been used as a complement to general anesthesia and an effective agent for postoperative analgesia. However, the influence of tramadol on the hemodynamic response following laryngoscopy and tracheal intubation is less known.
Methods: Forty patients of both sexes, 16-50 year old, ASA physicalstatus I or II, scheduled for elective surgery were randomly divided into equal groups in this prospective, double blind study. After obtaining the baseline data, the patient was given 3 µg/kg fentanyl (Group F) or 3 mg/kg tramadol (Group T). Then induction of anesthesia in a uniform and standardized manner was carried out by an anesthesiologist who was blind to the medication. The hemodynamic parameters were measured and recorded immediately after induction but prior to laryngoscopy, 3, 6, and 9 min after intubation, and before incision. We also observed any unusual effect in the postoperative care unit. Chi-square test, Student’s t-test and paired t-test were used for statistical comparison. A P less than 0.05 was considered statistically significant.
Results: All patients had a successful induction and intubation. Differences in baseline values were not significant, nor were the differences in the values following induction. After laryngoscopy and intubation, heart rate increased significantly above the baseline level in both groups. The increase of heart rate was significantly more at 6 and 9 mm (P＜0.05) and lasted longer in the tramadol group. After intubation, systolic, mean and diastolic arterial pressure (SAP, MAP, DAP) increased significantly above baseline in both groups too, except for DAP in fentanyl group. At 6 and 9 mm, the MAP and DAP were significantly higher in tramadol than in fentanyl group (P＜0.05). Six patients in tramadol group had mild pain on injection of tramadol.
Conclusions: When administered right before thiopental induction, 3 mg/kg tramadol did not display a better attenuation against the increase of hemodynamic profiles than did 3 µg/kg fentanyl following tracheal intubation.

並列關鍵字

Tramadol ； Pain: postoperative ； Hemodynamics