Effects of Morphine and Tramadol on Somatic and Visceral Sensory Function and Gastrointestinal Motility after Abdominal Surgery

Wilder‐Smith, Clive H.; Hill, Lee; Wilkins, Justin; Denny, Lynnette

doi:10.1097/00000542-199909000-00013

Cited by 84 publications

(35 citation statements)

References 34 publications

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“…Recently, several groups reported that tramadol has less effects on gastric emptying than morphine. 12,13 The significance of this finding with regard to clinical outcomes remains to be determined. R Re ef fe er re en nc ce es s …”

Section: Objectif : Le Tramadol [(1rs 2rs)-2-diméthylamino) Méthyl-mentioning

confidence: 99%

L’administration intramusculaire du tramadol augmente le pH gastrique pendant l’anesthésie

Minami

Ogata

Horishita

et al. 2004

Can J Anesth/J Can Anesth

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P Pu ur rp po os se e: : Tramadol, [(1RS, 2RS)-2-dimethylamino) methyl-1-(3-methoxyphenyl)-cyclohexanol hydrochloride], is an analgesic in clinical use. It has been reported that tramadol inhibits muscarinic type 3 receptor function, which primarily mediates smooth muscle contraction and glandular secretion. We investigated the effects of tramadol on the pH of gastric juices during anesthesia to determine whether tramadol inhibits secretion from the gastric glands.M Me et th ho od ds s: : ASA physical status I or II adult patients (n = 30) presenting for major elective orthopedic surgery of the upper extremities or mastectomy were enrolled. Patients were randomly assigned to receive treatment with tramadol (n = 10), famotidine (n = 10), or saline (n = 10). General anesthesia was then induced using propofol, vecuronium bromide, and fentanyl. After inducing anesthesia, the gastric pH was measured using pH test paper and, then, 100 mg tramadol, 20 mg famotidine, or saline were injected into the deltoid muscle. Three hours after starting the operation, gastric juice was again aspirated and its gastric pH measured.R Re es su ul lt ts s: : There were no differences in the pH before anesthesia between the three groups. By contrast, gastric pH was increased in the tramadol group by the same amount as it was in the famotidine group three hours after administering the drugs. Gastric pH of the saline, famotidine, and tramadol groups was 2.6 ± 2.5, 6.3 ± 2.0, and 6.4 ± 0.8, respectively. C Co on nc cl lu us si io on n: : These results suggest that tramadol inhibits the secretion of gastric acid. Objectif : Le tramadol, [(1RS, 2RS)-2-diméthylamino) méthyl-1-(3-méthoxyphényl)-cyclohexanol hydrochloride], est un analgésique d'usage clinique. On a montré que le tramadol inhibe la fonction des récepteurs muscariniques de type 3 dont le principal rôle est de servir de médiateur à la contraction des muscles lisses et à la sécrétion glandulaire. Nous avons examiné les effets du tramadol sur le pH des sucs gastriques pendant l'anesthésie afin de déterminer si le tramadol inhibe la sécrétion des glandes gastriques. Méthode : Des patients adultes d'état physique ASA I et II (n = 30) admis pour une intervention orthopédique majeure réglée aux membres supérieurs ou pour une mastectomie ont participé à l'étude. Ils ont été randomisés et ont reçu du tramadol (n = 10), de la famotidine (n = 10) ou une solution saline (n = 10). L'anesthésie générale

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Section: Objectif : Le Tramadol [(1rs 2rs)-2-diméthylamino) Méthyl-mentioning

confidence: 99%

L’administration intramusculaire du tramadol augmente le pH gastrique pendant l’anesthésie

Minami

Ogata

Horishita

et al. 2004

Can J Anesth/J Can Anesth

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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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“…However the observed effects may be of greater clinical significance for people where analgesic consumption is higher, such as in patients with mood disorders, younger people and those undergoing procedures associated with higher postoperative analgesic consumption including emergency, major and abdominal surgery [28,29]. Furthermore, the efficacy of tramadol is most of the time not sufficient for more than mild or moderate pain [30], and although it provides other benefits such as reduced respiratory depression [31,32], better management of neuropathic pain [33] and less impairment of gastrointestinal motor function [34,35], there are also a number of theoretical and practical limitations to its use in addition to the clinical significance of the observed interaction with ondansetron. These include involvement in other clinically relevant drug interactions [36], implication in the development of serotonin syndrome [37,38], a possible decrease in seizure threshold, particularly in those at higher risk of seizures [2], and an increased incidence of nausea and vomiting [2].…”

Section: Discussionmentioning

confidence: 99%

The effect of ondansetron on the efficacy of postoperative tramadol: a systematic review and meta-analysis of a drug interaction

2014

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SummarySeveral studies have investigated the presence of a drug interaction between tramadol and ondansetron that reduced the efficacy of tramadol postoperatively. Most of these studies were small and the results inconsistent, so we performed a systematic review and meta-analysis of randomised controlled trials comparing the cumulative dose of tramadol administered by patient-controlled analgesia within the first 24 h after surgery between subjects receiving tramadol alone and those who received tramadol with ondansetron. Six studies, with a total of 340 participants, met the selection criteria and were included in the meta-analysis. There was an increased tramadol requirement in patients receiving ondansetron. The standardised mean difference in tramadol requirements, expressed in terms of standard deviations (95% CI), was 1.03 (0.54-

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Effects of Morphine and Tramadol on Somatic and Visceral Sensory Function and Gastrointestinal Motility after Abdominal Surgery

Cited by 84 publications

References 34 publications

L’administration intramusculaire du tramadol augmente le pH gastrique pendant l’anesthésie

L’administration intramusculaire du tramadol augmente le pH gastrique pendant l’anesthésie

Wound closure tramadol administration has a short-lived analgesic effect

The effect of ondansetron on the efficacy of postoperative tramadol: a systematic review and meta-analysis of a drug interaction

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