To investigate the preemptive analgesia effects of tramadol on stress reaction during in patients undergoing laparoscopic hiatus hernia surgery.

Conduct prospective studying sixty patients undergoing laparoscopic hiatus hernia surgery of Xinjang Uygur Autonomous Region People′s Hospital from June to December 2016.All the patients were randomly divided into three groups with 20 each by double-blind design method.Tramadol preemptive analgesia group(group A): received tramadol 2.5 mg/kg intravenously 30 min before operation and 2 ml saline at the end of operation; Tramadol postoperative analgesia group(group B): received 2 ml saline 30 min before operation and tramadol 2.5 mg/kg intravenously at the end of surgery; Control group(group C): injected 2 ml saline 30 min before surgery and at the end of operation surgery.The patient′s mean arterial pressure(MAP), heart rate(HR), oxygen saturation(SpO₂), plasma cortisol and blood sugar levels were recorded and compared before injection, at the end of surgery and during extubation.After the extubation visual analogue scale(VAS)for pain was measured and observed the occurrence of nausea, vomiting, uroschesis and skin pruritus.

MAP and HR were significantly lower in group A and B than those in group C, while group A lower than B during extubation and at the end of operation(P<0.05). Blood glucose and cortisone in group A and B were significantly lower than those in group C, while group A is more slower than group B at the end of surgery and during extubation(P<0.05). VAS scores in group A and B were significantly lower than those in group C during extubation(P<0.05)but group A lower than group B(P<0.05).

Tramadol preoperative injection can reduce stress reaction during extubation and play good effect on analgesia.The mechanism may be related to preemptive analgesia.