Objective To investigate the effect of tramadol on perioperative insulin resistance in patients undergoing surgical operations with different trauma.Methods One hundred and twenty patients who had general and gynecology belly all numb surgical operation were divided into tramadol group and control group,each with 60 cases.Five minutes before skin incision,the tramadol group was given tramadol 1.5 mg/kg intravenously.followed immediately by a continuous infusion of 0.5 mg/kg per hour until the end of surgery,and the control group was given normal saline instead of tramadol.Blood samples were taken from vein for determination of plasma blood sugar,insulin concentrations before induction of anesthesia(T0),at the end of the operation(T1)and seven o'clock on the next morning(T2).The value of ISI Was calculated.Grading upon the trauma degree of surgical operation was divided into three groups(Ⅰ,Ⅱ,Ⅲsubgroup).Results The concentrations of blood sugar and insulin at Tohad no significant difference in Ⅰ,Ⅱ,Ⅲsubgroups in the tramadol group(P＞0.05).The concentrations of blood sugar and insulin at T1,T2 were increased significantly compared to T0 in each subgroup[To:(4.74 ±0.43)mmol/L,(15.25±1.22)U/L;T1:(5.35±0.47)mmol/L,(17.74±1.45)U/L;T2:(6.55±0.53)mmol/L,(18.59±1.56)U/L](P＜0.05),ISI was decreased(P＜0.05).The concentrations of blood sugar and insulin at T1,T2 were significantly lower in the tramadol group than those in the control group.The value of ISI was significantly higher in the tramadol group than that in the control group(P＜0.05).Conclusions The insulin resistance presents relation with the surgical operation degree.The severe the wound is,the bigger insulin resistance is.Tramadol can alleviate perioperative insulin resistance in patients undergoing surgical operations.