Effect of the dexmedetomidine combined with tramadol on preventing post-anesthetic hyperalgesia induced by remifentanil

Objective: To observe the effects and safety of the dexmedetomidine combined with tramadol on preventing post-anesthetic hyperalgesia induced by remifentanil. Methods: Eighty patients scheduled by operation were randomly divided into the control group(Group D), tramadol group(Group Q), dexmedetomidine group(Group Y) and dexmedetomidine combined with tramadol group(Group L)(20 cases each group). The HR and MAP in different stages, awakening time, trachea extubation time, VAS pain scores before and after operation, number of patients treated with supplementary analgesic drugs after 24 h of operation and adverse reactions were recorded. Results: The HR and MAP in group D and group Q at trachea extubation, after 5 and 10 min of extubation were significantly higher than those in group Y and group L(P<0.01), the differences of HR and MAP in Y and group L were not statistically significant(P>0.05). The awakening time in group L were longer than those in group D and group Q(P<0.05), the trachea extubation time in group Y were longer than that in group D(P<0.05). The VAS scores in group D at all postoperative time points were significantly higher than that before treatment(P<0.01). The VAS scores in group Q, Y and L at all postoperative time points were significantly less than in group D(P<0.01). The VAS scores in group L at all postoperative time points were significantly less than in group Q and L(P<0.01). The supplementary analgesic drugs in L group at postoperative 24 h was significantly less than that in group D, Q and Y(P<0.01), the differences of the incidence of nausea, vomiting and chills between four groups at postoperative 24 h were not statistically significant(P>0.05), the incidence of restless in group Y and group L were significantly less than that in group D and group Q(P<0.05 to P<0.01). Conclusions: The dexmedetomidine combined with tramadol can prevent post-anesthetic hyperalgesia induced by remifentanil, and provide good sedation and analgesia, stable hemodynamics during extubation, and do not increase the postoperative nausea and vomiting.