Analgesic efficacy of tramadol/acetaminophen and propoxyphene/acetaminophen for relief of postoperative wound pain

Lin, Feng Sheng; Lin, Wen Yu; Lai, Cheng‐Hung; Chen, Chien-Yu; Lin, Chih Peng; Lin, Tzu-Fu; Sun, Wei‐Zen

doi:10.1016/j.aat.2012.05.009

Cited by 6 publications

(4 citation statements)

References 11 publications

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“…In postoperative pain treatment, the administration of drugs with side effects that require interventions and disrupt the patient's vital functions increase costs and require additional staff, all of which limit their use. Recent studies showed that paracetamol is an analgesic with few side effects, a wide dosage range, and easy use (16,23). Tramadol is an opioid with few side effects also and it is thought to have good analgesic activity (24).…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Yılmaz¹,

Sarihasan²,

Kelsaka³

et al. 2015

Turk J Med Sci

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IntroductionDespite developments in the pathophysiology and treatment of pain, increased knowledge of pain management, the availability of new drugs, and complex drug delivery systems, the pain management of many patients after surgery remains inadequate. Studies have shown that successful postoperative analgesia after surgery prevents many side effects of pain, such as the inability to breathe at ease, the increase in the workload of the cardiovascular system, the development of thromboembolic events due to a delay in the mobilization of patient, and the increase in stress response due to the activation of the sympathetic nervous and neuroendocrine systems (1,2). Inadequate treatment of acute pain is the most common cause of chronic pain after surgery. The aim after surgery is to ensure that organ functioning returns to normal quickly by controlling pain as soon as possible (3).Today it is possible to achieve successful postoperative analgesia by selecting appropriate methods/routes of administration, agents, dosages, and dosage ranges. Opioids are the most widely used group of drugs in the treatment of postoperative pain due to their strong analgesic activities. However, opioid-related nausea, vomiting, pruritus, urinary retention, respiratory depression, sedation, and central nervous system depression have accelerated the search for analgesic drugs with better pain relief efficacy and fewer side effects (4).Research has reported gastric irritation, erosion, bleeding, and inhibition of platelet aggregation with nonsteroidal antiinflammatory drugs (NSAIDs), in addition to adverse effects on the secretion of uric acid and bleeding (5), thereby restricting their use. Side effects, such as systemic toxicity and prolonged sensory and motor responses, have also been reported with local anesthetic drugs used to provide pain control (6). Tramadol, a weak, effective synthetic opioid, has been shown to have relatively few side effects compared to other opioids, and its abuse or addiction potential is negligible (7). Paracetamol is a Background/aim: To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery. Materials and methods: Group P (paracetamol group) was given 1 g of paracetamol intravenously 30 min before the end of the operation and 1 g each day at 6-h intervals. Group T (tramadol group) was given 1.5 mg/kg of tramadol as a loading dose and patient-controlled analgesia for 1 day. Hemodynamic parameters, modified Aldrete score, Ramsay sedation scale score, patient satisfaction scale (PSS) score, visual analog scale (VAS) score, nausea/vomiting scale score, and additional analgesic needs/times were recorded.Results: PSS scores were significantly higher in Group T (P < 0.05). The total analgesic consumption was significantly higher in Group P. There were no significant differences in the VAS scores at any time points. Twenty-one patients in Group P and 8 patients in Group T needed additional analgesia (P < 0.05). The first additional analg...

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Section: Discussionmentioning

confidence: 99%

“…Recent studies showed that paracetamol is an analgesic with few side effects, a wide dosage range, and easy use (16,23). Tramadol is an opioid with few side effects also and it is thought to have good analgesic activity (24).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Yılmaz¹,

Sarihasan²,

Kelsaka³

et al. 2015

Turk J Med Sci

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show abstract

“…Another opioid, tramadol (TRAM), has been a suitable alternative for many patients. This has been reviewed thoroughly elsewhere …”

Section: Introductionmentioning

confidence: 99%

Simultaneous quantitation of meperidine, normeperidine, tramadol, propoxyphene and norpropoxyphene in human plasma using solid‐phase extraction and gas chromatography/mass spectrometry: Method validation and application to cardiovascular safety of therapeutic doses

Fernández

Olivera

Keller

et al. 2017

Rapid Comm Mass Spectrometry

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Rationale Several opioid analgesics have been related to the prolongation of cardiac repolarization, a condition which can be fatal. In order to establish a correct estimation of the risk/benefit balance of therapeutic doses of meperidine, normeperidine, tramadol, propoxyphene and norpropoxyphene, it was necessary to develop an analytical method to determinate plasma concentrations of these opioids. Methods Here we describe a method which incorporates strong alkaline treatment to obtain norpropoxyphene amide followed by a one‐elution step solid‐phase extraction, and without further derivatization. Separation and quantification were achieved by gas chromatography/electron ionization mass spectrometry (GC/EI‐MS) in selected‐ion monitoring mode. Quantification was performed with 500 μL of plasma by the addition of deuterated analogues as internal standards. Results The proposed method has been validated in the linearity range of 25–1000 ng/mL for all the analytes, with correlation coefficients higher than 0.990. The lower limit of quantification was 25 ng/mL. The intra‐ and inter‐day precision, calculated in terms of relative standard deviation, were 2.0–12.0% and 6.0–15.0%, respectively. The accuracy, in terms of relative error, was within a ± 10% interval. The absolute recovery and extraction efficiency ranged from 81.0 to 111.0% and 81.0 to 105.0%, respectively. Conclusions A GC/MS method for the rapid and simultaneous determination of meperidine, normeperidine, tramadol, propoxyphene and norpropoxyphene in human plasma was developed, optimized and validated. This procedure was shown to be sensitive and specific using small specimen amounts, suitable for application in routine analysis for forensic purposes and therapeutic monitoring. To our knowledge, this is the first full validation of the simultaneous determination of these opioids and their metabolites in plasma samples.

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“…Studies by Grundmann et al and Lin et al showed paracetamol to be an analgesic with few side eff ects, wide dosage range and easy use 41,42 . Cakan et al studied the effi cacy of paracetamol following lumbar disc surgery and concluded that paracetamol decreased visual analog scale (VAS) scores but did not decrease morphine consumption 29 .…”

Section: Fig 1 Diff Erences In Pain Perception Between Study Groupsmentioning

confidence: 99%

Analgesic Effect – Comparison of Paracetamol Administered Intermittently and Through Patient-Controlled Analgesia Pump after Lumbar Discectomy: a Prospective Clinical Study

Kurtović

Rotim

Batinica³

et al. 2017

acc

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SUMMARY -Lumbar discectomy is the most common surgical treatment for intervertebral disc extrusion. Postoperative pain is a common clinical problem that greatly aff ects the length of hospitalization, functional status and patient quality of life. Th e aim of this study was to compare the postoperative analgesic effi cacy of paracetamol administered intermittently and through patient-controlled analgesia (PCA) pump following single level lumbar discectomy. Patients who underwent elective lumbar discectomy of intervertebral disc extrusion at the L4-L5 level diagnosed by magnetic resonance of the lumbosacral spine were included in the study. Pain was assessed at regular intervals for 48 hours through a shortened version of McGill pain questionnaire translated in the Croatian language. When pain was monitored as a summarized variable for each measurement, PCA group signifi cantly stood up after 24 hours with better perception of pain compared to the intermittent group (c 2 -test, p<0.05). Adequate pain relief is an important aspect of postoperative care in spinal surgery patients. Postoperative use of paracetamol through PCA pump achieved better pain control and pain management versus postoperative use of intermittent paracetamol analgesia after lumbar discectomy.

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Analgesic efficacy of tramadol/acetaminophen and propoxyphene/acetaminophen for relief of postoperative wound pain

Cited by 6 publications

References 11 publications

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Simultaneous quantitation of meperidine, normeperidine, tramadol, propoxyphene and norpropoxyphene in human plasma using solid‐phase extraction and gas chromatography/mass spectrometry: Method validation and application to cardiovascular safety of therapeutic doses

Analgesic Effect – Comparison of Paracetamol Administered Intermittently and Through Patient-Controlled Analgesia Pump after Lumbar Discectomy: a Prospective Clinical Study

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