The Clinical Observation Of The Preventive Effect Of Tramadol On Restlessness During Palinesthesia Inchildren

Objective:To evaluate the preventive effect of tramadol on restlessness during palinesthesia in children undergoing tonsillectomy and(or) adenoidectomy surgery. Methods:Forty ASAⅠ,3～8 years old children undergoing selective tonsillectomy and (or) adenoidectomy were included in the study and allocated randomly into two groups, 2mg/kg of tramadol was administered intravenously after the induction in tramadol group and the same dosage neutral saline was administered in control group.Arterial pressure, electrocardiogram,heart rate,peripheral oxygen saturation were monitored continuously during the operation,record the surgery time,anesthesia time,extubation time At the time of palinesthesia,a blind observer accessed the Comfort score before extubation(the comfort score consists of eight categories:alertness,calmness/agitation,respirator response,physical movement,mean arterial pressure,heart rate,muscle tone and facial expression.each category has 0～5 point,there are forty points in all.A score of 8～16 points corresponds to deep sedation,17～26 indicates light sedation and 27～40 indicates inadequate sedation.A score of 17～26 points indicates satisfactory sedation.) and the degree of restlessness(no restlessness:0 point,mild restlessness:1 point,mid restlessness: 2 point,severe restlessness:3 point).observe the condition of adverse effect,such as postoperative hypoxemia,nausea and vomiting.Results:There was no significant difference among the surgery time,anesthesia time,extubation time,postoperative hypoxemia,nausea and vomiting in two group(P＞0.05).According to Comfort score, the satisfaction rate of the sedation was 80%in tramadol group and 45%in control group, there was significant difference between the two group(P=0.022),the rate of inadequate sedation was 10%in tramadol group and 50%in control group,there was significant difference between the two group(P=0.006).According to the restlessness score:The rate of no or mild restlessness was 85%in tramadol group and 45%in control group respectively,there was significant difference between the two group(P=0.008).The rate of severe restlessness was 5%in tramadol group and 30%in control group,there was significant difference between the two group(P=0.037).Conclusion:The preventive function of 2mg/kg tramadol can make the favorable sedation effect during palinesthesia and decrease the restlessness at the time of extubation in children undergoing tonsillectomy and(or) adenoidectomy surgery,meanwhile,2mg/kg tramadol didn't prolong the extubation time or increase the rate of the postoperative hypoxemia,nausea and vomiting.