Perioperative antinociceptive effects of tramadol. A prospective, randomized, double-blind comparison with morphine

Naguib, Mohamed; Seraj, Mohamed A.; Attia, Mounir; Samarkandi, Abdulhamid H.; Seet, Mustafa M; Jaroudi, Randa

doi:10.1007/bf03012458

Cited by 47 publications

(22 citation statements)

References 15 publications

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“…Theˆndings in a previous research supported our ndings. 20) Other researchers reported similar results to ourˆndings in postoperative eŠects of tramadol, meperidine and nalbuphine on nausea, vomiting and headache; 21) in the present study we observed more cases of nausea and vomiting with tramadol and remifentanil group had one case of headache and one case of abdominal pain, although not statistically shown to be signiˆcant. We concluded that two cases of palpitations in tramadol group arose from the agent's monoaminergic eŠects.…”

Section: Discussionsupporting

confidence: 89%

Postoperative Effects of Opioid Analgesics Administered via Continuous Perfusion and Patient Controlled Analgesia after Open Heart Surgery

Öztekin

İşsever

et al. 2006

YAKUGAKU ZASSHI

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Critical care nurses and physicians are familiar with the principles of patient controlled analgesia and the opioid analgesics' regimens and observations necessary for pain control in the postoperative cardiac surgical patients. The objective of the study was to compare the eŠects of morphine, fentanyl, meperidine, remifentanil and tramadol which were administered by patient controlled analgesia and continuous intravenous infusion combination on the various parameters. This study was designed as prospective randomised trial. Fifty patients undergone open heart surgery with sternotomy were entered equally intoˆve randomized groups. Visual analog scale was used by researcher nurse to assess the patient' pain status. Respiratory rate, heart rate and blood gases (pO 2 , pCO 2 , SaO 2 ), radial arterial blood pressures were measured in theˆrst 24 hrs postoperatively. Bolus requirements were determined by physicians and side eŠects of the analgesics were documented. Fentanyl group showed statistically higher levels of mean pO 2 ( p＝0.002). Meperidine had the lowest number of bolus doses ( p＝0.001). There were no signiˆcant diŠerences between the groups for pain management except higher visual analog scales on tramadol. Headache, stomachache and, palpitations were observed in our patients. Remifentanil, meperidine, fentanyl and morphine showed similar eŠect with each other for pain relief except tramadol.

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Section: Discussionsupporting

confidence: 89%

Postoperative Effects of Opioid Analgesics Administered via Continuous Perfusion and Patient Controlled Analgesia after Open Heart Surgery

Öztekin

İşsever

et al. 2006

YAKUGAKU ZASSHI

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“…Both drugs, in earlier clinical trials, have been used as a preemptive analgesic and found to be safe and effective. [3][4][5]12,13 The preemptive administration of gabapentin and tramadol approximately two hours before surgery appears rational in order to attain maximal plasma concentrations at the time of surgical stimuli. It has also been demonstrated that a single dose of 600 mg of gabapentin added to 60 mg slow release morphine increases pain tolerance to the cold pressure test in humans.…”

Section: Objectifmentioning

confidence: 99%

“…1,2 Gabapentin and tramadol both have demonstrated analgesic effects in clinical trials as a preemptive analgesic and in acute postoperative pain management; however experience with gabapentin is limited. [3][4][5][6] We investigated whether preemptive use of gabapentin 300 mg and tramadol 100 mg orally could reduce postoperative pain and fentanyl consumption in the initial 24 hr after laparoscopic cholecystectomy. We used a small dose of gabapentin (300 mg) as its bioavailability is 60% and decreases with increasing doses.…”

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confidence: 99%

L’usage préventif de gabapentine diminue significativement la douleur postopératoire et les besoins d’analgésique de secours lors d’une cholécystectomie laparoscopique

Pandey

Priye

Singh

et al. 2004

Can J Anesth/J Can Anesth

195

150

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P Pu ur rp po os se e: : To evaluate the comparative preemptive effects of gabapentin and tramadol on postoperative pain and fentanyl requirement in laparoscopic cholecystectomy.M Me et th ho od ds s: : Four hundred fifty-nine ASA I and II patients were randomly assigned to receive 300 mg gabapentin, 100 mg tramadol or placebo in a double-blind manner two hours before laparoscopic cholecystectomy under general anesthesia. Postoperatively, patients' pain scores were recorded on a visual analogue scale every two hours for the initial 12 hr and thereafter every three hours for the next 12 hr. Patients received fentanyl 2 µg·kg -1 intravenously on demand. The total fentanyl consumption for each patient was recorded.R Re es su ul lt ts s: : Patients in the gabapentin group had significantly lower pain scores at all time intervals (2.65 ± 3.00, 1.99 ± 1.48, 1.40 ± 0.95, 0.65 ± 0.61) in comparison to tramadol (2.97 ± 2.35, 2.37 ± 1.45, 1.89 ± 1.16, 0.87 ± 0.50) and placebo (5.53 ± 2.22, 3.33 ± 1.37, 2.41 ± 1.19, 1.19 ± 0.56). Significantly less fentanyl was consumed in the gabapentin group (221.16 ± 52.39 µg) than in the tramadol (269.60 ± 44.17 µg) and placebo groups (355.86 ± 42.04 µg; P < 0.05). Sedation (33.98%), nausea/retching/vomiting (24.8%) were the commonest side effects in the gabapentin group whereas respiratory depression (3.9%) was the commonest in the tramadol group and vertigo (7.8%) in the placebo group. C Co on nc cl lu us si io on n: : Preemptive use of gabapentin significantly decreases postoperative pain and rescue analgesic requirement in laparoscopic cholecystectomy. (2,65 ± 3,00; 1,99 ± 1,48; 1,40 ± 0,95; 0,65 ± 0,61) que ceux du groupe tramadol (2,97 ± 2,35; 2,37 ± 1,45; 1,89 ± 1,16; 0,87 ± 0,50) ou placebo (5,53 ± 2,22; 3,33 ± 1,37; 2,41 ± 1,19; 1,19 ± 0,56). La demande de fentanyl a été significativement plus basse avec la gabapentine (221,16 ± 52,39 µg) qu'avec le tramadol (269,60 ± 44,17 µg) ou le placebo (355,86 ± 42,04 µg; P < 0,05). La sédation (33,98 %), les nausées/haut-lecoeur/vomissements (24,8 %) ERIPHERAL tissue injury provokes peripheral sensitization (a reduction in the threshold of nociceptor afferent peripheral terminals) and central sensitization (an activity dependent increase in the excitability of spinal neurons). 1,2 These changes contribute to the postinjury pain hypersensitivity state which manifests as an increase in the responsiveness to noxious stimuli and a decrease in the pain threshold, both at the site of injury and in the surrounding uninjured tissue. 1,2 The optimal form of treatment is that applied pre, intra and postoperatively to preempt the establishment of pain hypersensitivity during and after surgery. The preemptive treatment could be directed at the periphery, at inputs along sensory axons, and at central neurons. Different treatment regimens could be used at different times relative to surgery to maximize the prevention of pain in response to different levels of sensory inputs. 1,2 Gabapentin and tramadol both have demonstrated analgesic effect...

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“…Several studies have demonstrated that tramadol was equally effective in controlling postoperative pain as morphine. 1,2 The synergy of monoaminergic and opioid activity achieves analgesic effects. 3 Administering analgesics before the patient emerges from general anesthesia may result in an "acceptable" comfort level for the patient in the early postoperative period.…”

Section: Brief Reportsmentioning

confidence: 99%

Wound closure tramadol administration has a short-lived analgesic effect

Naguib

Attia

Samarkandi

2000

Can J Anesth/J Can Anesth

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Purpose: To evaluate the effects of tramadol administration at wound closure on postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy.Methods: In a prospective, randomized, double-blind study 80 patients were allocated into two groups (n = 40 in each) to receive either 200 mg tramadol or placebo iv at the time of wound closure. Postoperatively, all patients received tramadol from a patient-controlled analgesia (PCA) device. Pain, analgesic consumption, vital signs and side effects were recorded postoperatively for 24 hr.Results: Administration of 200 mg tramadol at the time of wound closure was associated with a short-lived (60 min) reduction in pain scores and PCA consumption compared with placebo. Although the time to first request for analgesia after surgery was longer in patients who received tramadol at wound closure, there was no difference between the two groups with respect to pain scores or to the requirements of postoperative analgesia over the next 23 hr. The cumulative PCA consumption of tramadol in 24 hr was 139.4 ± 108 and 102.4 ± 106 mg in the placebo and tramadol groups, respectively (P = 0.06).

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Perioperative antinociceptive effects of tramadol. A prospective, randomized, double-blind comparison with morphine

Cited by 47 publications

References 15 publications

Postoperative Effects of Opioid Analgesics Administered via Continuous Perfusion and Patient Controlled Analgesia after Open Heart Surgery

Postoperative Effects of Opioid Analgesics Administered via Continuous Perfusion and Patient Controlled Analgesia after Open Heart Surgery

L’usage préventif de gabapentine diminue significativement la douleur postopératoire et les besoins d’analgésique de secours lors d’une cholécystectomie laparoscopique

Wound closure tramadol administration has a short-lived analgesic effect

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