Comparision Of Tramadol And Lidocaine In Abating Extubation Reaction

Aim:During the extubation period of general anesthesia, great alteration of patients'respiration and circulation system can come out due to actions like sputum suction and extubation, pain, the stimulation of the trachea and resuming of respiration and swallow reaction, which shows in patients as tachycardia, hypertension, cough and dysphoria and leads to high intracranial, abdominal, and intraocular pressure. This is extremely dangerous for those patients who are old and especially with cardiac and cerebral diseases. It has been a focus for anesthetists that how to control and minimize the peri-extubation reaction. In this article, we try to find a better way to achieve this by comparing tramadol and lidocaine in abating the extubation reaction.Methods: Sixty patients of ASA I-II are selected who are undergoing selective operation,with age from 21 to 60, and who have no internal diseases. The patients are divided into three groups randomly: Group C (control), Group T (tramadol) and group L (lidocaine). These groups are given the injection of tramadol 1mg/kg, 2% lidocaine 1.5mg/kg and 5ml saline seperately 10 minutes before the end of the operation. SBP, DBP, HR are recorded at different times of pre-anesthesia (T0), 2 minutes before extubation (T1), extubation (T2) and 2 minutes post-extubation (T3),as well as cough reaction degree, conciousnessdegree, revival time, VAS grade, and whether dysphoria , nausea and vomitting or not. All the data are shown in the form of X±S, and processed with SPSS (statistical package for social science) statistical software. Student t test is performed to get the variation between and in the groups.Results: SBP, DBP and HR all rise in three groups in T1 and T2 compared with T0. But differentiation exists between Group T and Group C in the degree of BP changes. So is it for HR in Group L. The revival time in Group T is longer than the other two groups. The degree of cough reaction goes as Group T < Group L < Group C. And patients in Group T get the lowest VAS grade of all. More patients in Group C get dysphoria and more in Group T have the symptoms like nausea and vomitting.Conclusion: Both tramadol and lidocaine can abate the extubation reaction. Tramadol has a better effect in analgesia and sedation and it can keep a relatively stable hemodynamics. And also it can ease cough ,prevent and cure chilling and dysphoria. While lidocaine is good at curing tachycadia and havs no delay on revival time. In all, tramadol is more effective than lidocaine in abating extubaion reaction.