Der Einfluß von Buprenorphin und Tramadol auf die CO<sub>2</sub>-Antwort in der unmittelbar postoperativen Phase nach Allgemeinanästhesie

Klose, R.; Ehrhart, A; Jung, R

doi:10.1055/s-2007-1003842

Cited by 13 publications

(3 citation statements)

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“…Thus, the view that tramadol is a weak opioid analgesic [21,22,24,43,44] is supported by our data. Other than anpirtoline, tramadol also produced a significant decrease in tracking performance indicating a sedative action.…”

Section: Discussionsupporting

confidence: 88%

“…Tramadol produced only a small decrease in the subjective estimates of pain intensity (P < 0.01) but revealed analgesic properties with regard to the decrease of the CSSERP amplitude. Thus, the view that tramadol is a weak opioid analgesic [21,22,24,43,44] is supported by our data. Other than anpirtoline, tramadol also produced a significant decrease in tracking performance indicating a sedative action.…”

Section: Discussionsupporting

confidence: 88%

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A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline [see comments]

Hummel

Friedel

et al. 1994

Brit J Clinical Pharma

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1 The pain relieving properties of imipramine (100 mg orally), tramadol (150 mg orally), and anpirtoline (60 mg orally) were compared in 16 healthy subjects in a cross-over, double-blind, randomized, and placebo-controlled study. Anpirtoline exhibits analgesia which is possibly mediated via serotoninergic pathways, whereas tramadol exerts its effects at opioid receptors. The pain-relieving effect of the tricyclic antidepressant imipramine may involve both serotoninergic and opioid mechanisms. 2 Chemo-somatosensory event-related potentials (CSSERP) were recorded after painful stimulation of the nasal mucosa with carbon dioxide. Subjects rated the perceived intensity of the stimuli by means of a visual analogue scale. In addition, acoustically evoked responses were recorded, the spontaneous EEG was analyzed in the frequency domain, the subjects' vigilance was assessed in a tracking task, and side effects of the drugs were monitored. 3 Anpirtoline and tramadol produced a decrease of both CSSERP amplitudes and subjective estimates of pain, the effects of the former compound being greater. In contrast, after administration of imipramine no change of CSSERP amplitudes could be detected, whereas the subjective estimate of pain intensity decreased significantly. This was accompanied by a significant decrease of arousal indicating that pain relief produced by acute administration of imipramine was primarily related to its sedation action.4 The analgesic properties of anpirtoline were demonstrated in man. Tramadol was characterized as a weak opioid analgesic. In contrast, imipramine appeared to produce its pain-relieving effects predominantly by non-specific actions. It is hypothesized that different analgesics may change ERP sources in a drug-specific manner.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 88%

A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline [see comments]

Hummel

Friedel

et al. 1994

Brit J Clinical Pharma

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“…Dazu wurden Nasensonden benutzt, um nicht durch Tätigkeiten am Patienten die Atmung zu beeinflussen. Mehrere Arbeitsgruppen hatten eine geringere, nicht ausschließbare [29] Atemdepression für das Tramadol nachgewiesen im Vergleich mit Substanzen wie Morphin, Buprenorphin, Pentazocin, Piritramid und Pethidin [6,17,24,35,37,38]. In der vorliegenden Studie gab es keine gravierenden pCO 2 -Anstiege, so daß für keine der untersuchten Substanzen eine klinisch relevante Atemdepression nachgewiesen wurde.…”

Section: Studienkritikunclassified

Sind Tramadol-Enantiomere für die postoperative Schmerztherapie besser geeignet als das Racemat?

et al. 1998

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The goal of this prospective, randomised and double-blind pilot-study was to investigate the analgesic potency and the side-effects of tramadol enantiomers in clinical practice. One hundred patients recovering from orthopaedic surgery with a postoperative pain intensity of more than 50 on a visual analogue scale 0-100 mm (Table 1) were recruited for the study. They were treated in a randomised, double-blind way with a maximal dose of 150 mg i.v.(+)-,(-)-tramadol, racemate, or 15 mg i.v. morphine or saline in the placebo group (5 groups, 20 patients each). The primary criterium of efficacy was the number of responders defined as patients with a pain reduction of at least 20 on VAS after 40 min. In case of pain, responders were allowed to continue with the double-blind drug up to six hours. The non-responders were treated with morphine as the rescue analgesic. The secondary criterium was the incidence and severity of side-effects. Six patients terminated the study prematurely. One patient was excluded because of an allergic reaction to morphine, one patient could not be treated sufficiently with morphine, four were excluded because of protocol violations. There were 8 responders in the (+)-tramadol-,6 in the (-)-tramadol- and 6 in the racemate group, 16* (P < 0.05) in the morphine group, and 5 in the placebo group. Pain intensity after 40 min was reduced by 20 (p < 0.05), 17 (p < 0.05), 17 (p < 0.05), 36 (p < 0.01 vs placebo, p < 0.05 vs (+)-,(-)-tramadol, and racemate group) and 5 mm on the VAS in the (+)-, (-)-, (+/-)-tramadol-, morphine- and placebo-group, respectively. Thirty eight adverse events like nausea, vomiting, PCO2-increase, and urinary retention occurred in 20 patients, most frequently in the (+)-tramadol- and morphine group. Sedation was significantly less profound in the (-)-tramadol group 1-4 h postoperatively. There were no side-effect in the tramadol racemate group. The enantiomers were equal to the racemate in analgesic potency, but inferior by far to morphine. They showed more adverse events and, hence, can not be preferred to the racemate in postoperative pain therapy.

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Zentral wirksame Analgetika vom Typ Opioid

Waldvogel¹

2001

Analgetika Antinozizeptiva Adjuvanzien

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Der Einfluß von Buprenorphin und Tramadol auf die CO₂-Antwort in der unmittelbar postoperativen Phase nach Allgemeinanästhesie

Cited by 13 publications

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A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline [see comments]

A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline [see comments]

Sind Tramadol-Enantiomere für die postoperative Schmerztherapie besser geeignet als das Racemat?

Zentral wirksame Analgetika vom Typ Opioid

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Der Einfluß von Buprenorphin und Tramadol auf die CO2-Antwort in der unmittelbar postoperativen Phase nach Allgemeinanästhesie

Cited by 13 publications

References 0 publications

A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline [see comments]

A comparison of the antinociceptive effects of imipramine, tramadol and anpirtoline [see comments]

Sind Tramadol-Enantiomere für die postoperative Schmerztherapie besser geeignet als das Racemat?

Zentral wirksame Analgetika vom Typ Opioid

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Der Einfluß von Buprenorphin und Tramadol auf die CO₂-Antwort in der unmittelbar postoperativen Phase nach Allgemeinanästhesie