A comparative study on the analgesic effect of tramadol, tramadol plus magnesium, and tramadol plus ketamine for postoperative pain management after major abdominal surgery

Ünlügenç, H.; Gündüz, Murat; Özalevli, M.; Akman, Hasan O.

doi:10.1034/j.1399-6576.2002.460817.x

Cited by 64 publications

(41 citation statements)

References 27 publications

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“…Accordingly, intrathecally administered NMDA receptor antagonists produce antinociception on thermal, chemical and neuropathic pain tests [55] . In line with this evidence, ketamine, a nonselective NMDA receptor antagonist, improved tramadol analgesia and patient comfort and decreased the amount of tramadol required for pain management in abdominal surgery [5] . As previously mentioned, gabapentin is able to affect glutamatergic neurotransmission by reducing glutamate release and Ca 2+ infl ux by different mechanisms which includes the closing of voltage-dependent Ca 2+ channels.…”

mentioning

confidence: 75%

“…Tramadol is effective in reducing moderate to severe postoperative pain with an overall effi cacy similar to that of morphine or alfentanil. Previous clinical studies have shown that adding magnesium, ketamine [5] [6] or acetylsalicylate [7] to tramadol improved analgesia and patient comfort and decreased the amount of tramadol required for pain management. Studies in animals supporting these interactions are still lacking.…”

Section: Introductionmentioning

confidence: 99%

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Synergic Antinociceptive Interaction between Tramadol and Gabapentin after Local, Spinal and Systemic Administration

Granados‐Soto

Argüelles²

2005

Pharmacology

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The possible interaction between tramadol and gabapentin on formalin-induced nociception in the rat was assessed. Tramadol, gabapentin or a fixed-dose ratio combination of gabapentin and tramadol were administered peripherally, spinally and orally to rats, and the antinociceptive effect was determined in the 1% formalin test. Isobolographic analyses were used to define the nature of the interactions between drugs. Tramadol, gabapentin and tramadol-gabapentin combinations produced a dose-dependent antinociceptive effect when administered locally, spinally or orally. ED₃₀ values were estimated for the individual drugs and isobolograms were constructed. Theoretical ED₃₀ values for the combination estimated from the isobolograms were 126.8 ± 11.1 µg/paw, 23.1 ± 2.6 µg/rat, and 2.23 ± 0.32 mg/kg for the local, intrathecal and oral routes, respectively. These values were significantly higher than the actually observed ED₃₀ values which were 13.3 ± 2.1 µg/paw, 8.1 ± 0.6 µg/rat and 0.71 ± 0.10 mg/kg, indicating a synergistic interaction. Although efficacy was not improved, local peripheral administration resulted in the highest increase in potency, being about tenfold. Spinal and systemic administration increased potency threefold. Data indicate that low doses of the tramadol-gabapentin combination can interact synergistically to reverse formalin-induced nociception and may represent a therapeutic advantage for clinical treatment of inflammatory pain.

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mentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

Synergic Antinociceptive Interaction between Tramadol and Gabapentin after Local, Spinal and Systemic Administration

Granados‐Soto

Argüelles²

2005

Pharmacology

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“…Nonsteroidal anti-inflammatory drugs, opioid agonist-antagonists and mixed analgesics like tramadol, with and without magnesium, have also been used successfully. [5][6][7] Use of the anesthetic agent ketamine has also been reported during PCA. Ketamine has been used in conjunction with a variety of different analgesic agents intravenously, epidurally, and during wound infiltration via a patient-controlled delivery system.…”

Section: Introductionmentioning

confidence: 99%

Ketamine patient-controlled analgesia for dysesthetic central pain

Cohen

DeJesus

2004

Spinal Cord

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Study Design: Case report. Objectives: To describe the first use of intravenous (IV) ketamine as the sole agent in a patientcontrolled analgesic delivery system (ie PCA) in a patient with cervical syringomyelia. Setting: A tertiary-care university teaching hospital in New York City. Methods: A 41-year-old tetraplegic female on high-dose opioids suffering from intractable dysesthetic central pain received her best pain relief from a low-dose ketamine infusion after failing trials with multiple neuropathic medications. After several weeks of titrating her infusion rate up and down, she was switched to an IV ketamine PCA device. Results: The patient was maintained on an IV ketamine PCA for almost 1 year under the following settings: 2.7 mg/h basal rate; 2.7 mg/h demand dose; 15 min lockout period. Although she continues to report some pain, it has dramatically decreased since the ketamine PCA was instituted, enabling us to significantly reduce her opioid dosage. Conclusions: Ketamine PCA may be a viable treatment option in patients suffering from intractable central pain. The rationale for this treatment, along with dosing guidelines and possible drawbacks, is discussed.

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“…Magnesium sulfate has also been previously investigated as a possible adjuvant for postoperative analgesia [13][14][15][16][17][18][19][20][21][22][23] . However; relatively few studies have been conducted on the effects of postoperative intravenous magnesium administration (as an infusion) over a 24-hour period 17,[21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

“…However; relatively few studies have been conducted on the effects of postoperative intravenous magnesium administration (as an infusion) over a 24-hour period 17,[21][22][23] .…”

Section: Introductionmentioning

confidence: 99%

Comparison of the effects of magnesium and ketamine on postoperative pain and morphine consumption. A double-blind randomized controlled clinical study

et al. 2016

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PURPOSE:To compare the effects of magnesium sulfate and ketamine on postoperative pain and total morphine consumption in a placebo-controlled design. METHODS:One hundred and twenty women scheduled for total abdominal hysterectomy were included in this prospective, randomized, double-blind study. Postoperatively, when the Numeric Pain Rating Scale (NPRS) was four or more, IV-PCA morphine was applied to all patients. The patients were randomized into three groups: Group K ketamine, Group M magnesium, and Group C saline received as infusion. Total morphine consumption for 48h, pain scores, adverse effects, and patients' satisfaction were evaluated. RESULTS:Total morphine consumption was significantly lower in Group K (32.6±9.2 mg) than in Group M (58.9±6.5 mg) and in Group C (65.7±8.2 mg). The satisfaction level of patients in Group K was higher than the other two groups (p<0.05). Pruritus and nausea were observed more frequently in Group C. CONCLUSİON:The addition of ketamine to IV-PCA morphine reduces the total consumption of morphine without psychotic effects; however, magnesium did not influence morphine consumption.

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A comparative study on the analgesic effect of tramadol, tramadol plus magnesium, and tramadol plus ketamine for postoperative pain management after major abdominal surgery

Abstract: Adding magnesium or ketamine to tramadol improved analgesia and patient comfort and decreased the amount of tramadol required for postoperative pain management after major abdominal surgery.

Cited by 64 publications

References 27 publications

Synergic Antinociceptive Interaction between Tramadol and Gabapentin after Local, Spinal and Systemic Administration

Synergic Antinociceptive Interaction between Tramadol and Gabapentin after Local, Spinal and Systemic Administration

Ketamine patient-controlled analgesia for dysesthetic central pain

Comparison of the effects of magnesium and ketamine on postoperative pain and morphine consumption. A double-blind randomized controlled clinical study

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