Hypoxaemia after lower abdominal surgery: Comparison of tramadol and morphine

Langford, R. M.; Bakhshi, K.N.; Moylan, S.L.; Jm, Foster

doi:10.1016/s1366-0071(98)80002-8

Cited by 7 publications

(3 citation statements)

References 10 publications

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“…It is important to note that these findings are consistent with the literature on IV tramadol, in which clinical studies conducted in Europe reported similar effectiveness and lower or similar AE rates among patients receiving tramadol relative to patients receiving comparator opioid products [12,15,[22][23][24][25][26][27][28][29].…”

Section: Discussionsupporting

confidence: 82%

Intravenous Tramadol is Effective in the Management of Postoperative Pain Following Abdominoplasty: A Three-Arm Randomized Placebo- and Active-Controlled Trial

Minkowitz¹,

Salazar

Leiman³

et al. 2020

Drugs R D

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Background and Objective Oral tramadol, an atypical opioid approved in the United States (US) since 1995 and a Schedule IV controlled substance, has less abuse liability compared to Schedule II conventional opioids. Intravenous (IV) tramadol is not available in the US, but has the potential to fill a gap between non-opioid medications and conventional opioids for treatment of acute pain. This study evaluates IV tramadol in the management of postoperative pain compared to placebo and standard-of-care active control. Methods A phase 3, multicenter, double-blind, three-arm, randomized, placebo-and active-controlled, multiple-dose, parallel-group study was conducted to evaluate the efficacy and safety of 50 mg IV tramadol versus placebo and 4 mg IV morphine over 48 h in patients with postoperative pain following abdominoplasty surgery. Results IV tramadol was statistically superior (p < 0.05) to placebo and comparable to IV morphine for the primary and all key secondary efficacy outcomes and demonstrated numerically lower rates for the incidence of most common treatmentemergent adverse events (TEAEs) compared to morphine. No unexpected findings were observed for TEAEs, laboratory tests, vital signs, or electrocardiograms (ECGs). Over 90% of patients completed the study. Conclusion The study demonstrated that IV tramadol 50 mg is highly effective in the management of postoperative pain following abdominoplasty. The consistency of effects between tramadol and morphine (as compared to placebo) for primary and key secondary endpoints validates the efficacy of tramadol observed. The study also provided direct evidence of improved tolerability of IV tramadol over a standard-of-care conventional Schedule II opioid. IV tramadol may become a useful option in patients where exposure to conventional opioids is not desired.

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Section: Discussionsupporting

confidence: 82%

Intravenous Tramadol is Effective in the Management of Postoperative Pain Following Abdominoplasty: A Three-Arm Randomized Placebo- and Active-Controlled Trial

Minkowitz¹,

Salazar

Leiman³

et al. 2020

Drugs R D

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“…No somatic or visceral sensitization was evident during the infusions 99 . After lower abdominal surgery, IV tramadol produces a significantly lower incidence of arterial hypoxaemia than IV morphine 93 . However, when used in combination with other central nervous system depressants (e.g., other opioids), respiratory changes may be seen 2,3 .…”

Section: Clinical Use (A) Acute Painmentioning

confidence: 92%

“…In contrast to postoperative bolus administration, this may allow the patient to awake pain-free with a low incidence of side-effects (nausea, dizziness) 2,6 . A 3 mg/kg IV dose appears to be the most suitable for acute pain of moderate to severe intensity and it causes minimal respiratory depression 6,93,94 .…”

Section: Clinical Use (A) Acute Painmentioning

confidence: 99%

Tramadol—Present and Future

Shipton

2000

Anaesth Intensive Care

182

134

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The atypical opioid, tramadol, has recently been introduced into Australia and New Zealand. Tramadol's efficacy in a wide range of acute and chronic pain states, its multi-formulation availability, and its low serious side-effect potential at high doses and in prolonged therapy, combine to bestow on it a user-friendly profile, for short-and long-term use in hospitals and communities. This paper reviews the following: its formulation and routes of administration; its unique enantiomeric biochemistry and metabolism; its triple mechanisms of action; its pharmacokinetics and pharmacodynamics; its analgesic efficacy compared with other opioids; the indications for its clinical use in a variety of acute and chronic (including cancer) painful states; its specific use in the elderly, in paediatric and in obstetric patients; its adverse event (including drug interaction) and safety profile; its advantages in terms of its relative lack of respiratory depression, major organ toxicity and histamine release, and dependence and abuse potential. The review looks at new uses for this drug and what can be expected in this area in the future.

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Tramadol: Its role in acute pain management

Ballantyne

1998

Acute Pain

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Hypoxaemia after lower abdominal surgery: Comparison of tramadol and morphine

Cited by 7 publications

References 10 publications

Intravenous Tramadol is Effective in the Management of Postoperative Pain Following Abdominoplasty: A Three-Arm Randomized Placebo- and Active-Controlled Trial

Intravenous Tramadol is Effective in the Management of Postoperative Pain Following Abdominoplasty: A Three-Arm Randomized Placebo- and Active-Controlled Trial

Tramadol—Present and Future

Tramadol: Its role in acute pain management

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