Effect Of Pre-emptive Analgesia By Tramadol Combined With Dexamethsone On Postoperation Analgesia Of Elderly Patients

Objective:To observe the effect of pretreatment by tramadol combined with dexamethsone on postoperation analgesia of elderly patients.Methods:Totally 90 elderly patients for abdominal cavity surgery under general anesthesia were randomly divided into 3 groups with 30 cases each: group A was treated with tramadol 2.5mg/kg+dexamethasone 10 mg by intravenous injection. Group B was treated with tramadol 2.5mg/kg+saline 2ml while group C was treated with saline 5ml by intravenous injection before the skin incision. All patients were under total intravenous anesthesia by the same anesthesia induction of endotracheal intubation. Maintenance of anesthesia was conducted by continuous infusion of propofol and remifentanil with micro-injection pump, and CIS-Atracurium was added discontinuously to achieve muscle relaxant effects. At the end of the surgery all patients were connected to intravenous patient-controlled analgesia pumps(PCIA), and same formula was used in all analgesia pumps: sufentanil 2μg/kg+dezocine 0.2mg/kg+palonosetron 0.25 mg, diluted with 0.9% sodium chloride injection to 100 ml. Visual simulation score(VAS),comfortable degrees score(BCS), times of effective pressing PCIA and the side effects were monitored and recorded respectively at six points: Postoperative 2h(T1), 4h(T2),8h(T3), 12h(T4), 24h(T5) and 48h(T6).Results:VAS score in group C were higher than group A and B at all six points(P<0.05);VAS score in group A were lower than group B at T1, T2, T3, T4(P<0.05), while no difference could be seen at T5, T6 between the two groups(P>0.05). BCS score in group C at each point were lower than group A and B(P<0.05). Times of effective pressing PCIA pump at T1, T2, T3, T4, T5 were higher than group A and group B(P<0.05); Times of group A at T1, T2, T3, T4 were lower than group B(P<0.05), while at T5, T6 no statistical difference could be seen between the two groups(P>0.05). Total times of effective pressing was highest in group C and lowest in group A(P<0.05). The incidence of nausea and vomiting in group A was significantly lower than group B and group C(P<0.05).Conclusions:Pretreatment by tramadol combined with dexamethasone could significantly alleviate postoperative pain in elderly patients, improve satisfaction of perioperative analgesia in elderly patients, reduce the consumption of analgesic after operation and side effects. The effect under the combination of tramadol and dexamethasone surpasses using tramadol alone.