전정맥마취 동안 tramadol의 수술 중 각성에 대한 영향 = Effect of Tramadol on Intraoperative Awareness during Total Intravenous anesthesia

다국어 초록 (Multilingual Abstract)

Background and Objectives: Tramadol is a central acting, opioid-like analgesic commonly used for analgesia during anesthesia. Previous studies have suggested that the use of tramadol during general anesthesia may be associated with awareness. This study is aimed to investigate the effect of tramadol on the bispectral index (BIS) during total intravenous anesthesia. Materials and Methods: One hundred fifty adults, ASA class 1 and 2 patients, scheduled for general anesthesia for elective surgical procedures were included in this study. None of the patients were premedicated and anesthesia was induced with propofol 2 mg/kg and maintained with air-oxygen (FiO₂ 0.5) and doses for remifentanil and propofol, adjusted to keep the BIS between from 50 and 60. Forty minutes before completing surgery, the subjects were randomly allocated into 3 groups to receive saline (C group), tramadol 1.5 mg/kg (T1 group) or 3.0 mg/kg (T2 group) intravenously. Hemodynamics and BIS values were then recorded every 5 minutes until completion of the operation, during which time the concentrations of desflurane were not modified. Results: The mean BIS values after tramadol administration weren’t significantly different from the control group throughout the period of observation. No significant changes in the hemodynamics were noted, except systolic and diastolic arterial blood pressure in the T1 and T2 groups significantly increased in the first 5 minutes after the tramadol injection. Conclusions: The results indicate that the administration of tramadol during total intravenous anaesthesia with propofol-remifentanil, adjusted to keep the BIS between from 50 to 60, does not modified BIS values. So, we propose that tramadol can be safely administered as preventive analgesia without concern about intra-operative awareness.