Fentanyl versus tramadol with levobupivacaine for combined spinal-epidural analgesia in labor

Chatrath,; Khetarpal, Ranjana; Sharma, Sanjay; Kumari, Poonam; Sudha,; Bali, Kusum

doi:10.4103/1658-354x.154700

Cited by 9 publications

(4 citation statements)

References 16 publications

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“…Some reports claim that the rate of cesarean section in China is currently >40% ( 1 ). Based on this, enhancing the level of sedation in the delivery process of cesarean section is of great significance in order to improve the outcome of delivery, and to improve the comfort levels of women during cesarean delivery ( 2 ).…”

Section: Introductionmentioning

confidence: 99%

Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia

Jiang

Wang

et al. 2017

Experimental and Therapeutic Medicine

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We conducted the present study to investigate the effects of the different loading doses of dexmedetomidine hydrochloride in the prevention of adverse reactions after combined spinal-epidural anesthesia. A total of 200 patients that were admitted to the Department of Obstetrics at the Second Affiliated Hospital of Xi'an Jiaotong University hospital and treated with cesarean section through the use of combined spinal-epidural anesthesia from December, 2014 to June, 2016, were randomly divided into 4 groups. The therapeutic regimens of patients were shown as follows: group A was administered an intravenous pump of 10 ml/l physiological saline in surgery until the end of the delivery. group B was administered 0.2 µg/kg dexmedetomidine. group C was administered 0.4 µg/kg dexmedetomidine. group D was administered 0.6 µg/kg dexmedetomidine. The anesthesia plane was adjusted to the level below the T10 plane. After the onset of anesthesia, participants of each group were treated with an intravenous pump of dexmedetomidine at loading dose. After intravenous pumping for 10 min in each group during the surgery, patients were administered with an intraoperative maintenance dose of 0.2 µg/kg/h until the end of the delivery. The heart rate (HR), mean arterial pressure (MAP), Narcotrend index (NI), Ramsay sedation score and the incidence of adverse reactions at each time-point of the start of drug administration (T0), 10 min (T2), 30 min (T3), 60 min (T4), 90 min (T5) and the end of surgery (T6) were recorded. Within 24 h post-delivery, the degree of amnesia from using dexmedetomidine until the end of the delivery were followed up. Compared to group A and T0, the HRs of participants at T3-6 in groups B and C were decreased. The MAP at T1 in group D was increased. In groups B and C, the NIs were significantly decreased at T2-6, the Ramsay scores were increased at T3-6, and the differences were statistically significant (P<0.05). The follow-up within 24 h after delivery showed that the degree of anterograde amnesia from groups B to D was significantly higher than group A, with statistically significant difference (P<0.05). A combined spinal-epidural anesthesia with 0.6 µg/kg loading dose of dexmedetomidine, by intravenous pumping within 10 min before cesarean section, can achieve a satisfied sedative effect at 30 min after administration. It maintains the characteristics of intraoperative hemodynamic stability and less adverse reactions. Therefore, it is of great significance to improve the quality of cesarean section delivery.

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Section: Introductionmentioning

confidence: 99%

Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia

Jiang

Wang

et al. 2017

Experimental and Therapeutic Medicine

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“…Chatrath et al[ 17 ] compared the addition of 25 mcg fentanyl and 25 mg tramadol with the administration of levobupivacaine during combined spinal-epidural anesthesia in labor. Adding tramadol to a local anesthetic provided prolonged analgesia with minimal side effects.…”

Section: Discussionmentioning

confidence: 99%

Evaluatıon Of Anaesthetic And Analgesic Effects Of Intrathecal Tramadol Vs Fentanyl Administration

Ozer¹,

Türk²

2018

Sisli Etfal

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Objectives: The aim of this study was to examine the anesthetic and analgesic effects of intrathecal tramadol compared with intrathecal fentanyl added to bupivacaine and that of a placebo added to bupivacaine in patients undergoing elective transurethral procedures. Methods: The anesthetic and analgesic efficacy of intrathecal tramadol hydrochloride (HCL) was assessed against a local anesthetic in this prospective, double-blind, randomized study of 146 American Society of Anesthesiologists classification I-III patients who underwent an elective transurethral procedure. A lumbar intrathecal block was performed using bupivacaine heavy 0.5 % combined with either tramadol HCL, fentanyl, or saline for surgery. Each group received 12.5 mg bupivacaine with 50 μg (1 mL) fentanyl, 12.5 mg bupivacaine with 10 mg (1 mL) tramadol, or 12.5 mg bupivacaine with 1 mL preservative-free saline. Results: The saline group experienced more pain than patients in the tramadol HCL and fentanyl groups (p<0.05). The mean time to regression of the sensory block to the S1-2 segment was significantly longer in the fentanyl group compared with the tramadol and saline groups (p<0.05). The incidence of complications was similar. Conclusion: Fentanyl added to a local anesthetic provided longer postoperative analgesia compared with tramadol added to a local anesthetic.

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“…Intraoperative use of tramadol is limited in favor of other pure opioid agonists; however, tramadol may be administered in the perioperative period as part of an effective multimodal pain regimen [38]. Tramadol has also been utilized as an adjunct to local anesthetic for a neuraxial blockade via an intrathecal approach, epidural, or combined spinal-epidural with varying success [41][42][43]. Adjunct agents are a method to prolong the duration of the blockade while minimizing unwanted side effects.…”

Section: Tramadolmentioning

confidence: 99%

New Serotonin-Norepinephrine Reuptake Inhibitors and Their Anesthetic and Analgesic Considerations

Fanelli

Weller

Liu

2021

Neurology International

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Serotonin-norepinephrine reuptake inhibitors (SNRIs) inhibit the presynaptic neuronal uptake of serotonin and norepinephrine and prolong the effects of the monoamines in the synaptic cleft within the central nervous system, leading to increased postsynaptic receptor activation and neuronal activities. Serotonin-norepinephrine reuptake inhibitors can have multiple clinical indications, including as the first-line agents for the management of depression and anxiety, and as analgesics in the treatment of chronic pain. The effects of reuptake inhibition of norepinephrine and serotonin are often dose-dependent and agent-dependent. There are five FDA-approved serotonin-norepinephrine reuptake inhibitors (desvenlafaxine, duloxetine, levomilnacipran, milnacipran and sibutramine) currently being marketed in the United States. As the COVID-19 pandemic significantly increased the incidence and prevalence of anxiety and depression across the country, there are significantly increased prescriptions of these medications perioperatively. Thus, anesthesiologists are more likely than ever to have patients administered with these agents and scheduled for elective or emergency surgical procedures. A thorough understanding of these commonly prescribed serotonin-norepinephrine reuptake inhibitors and their interactions with commonly utilized anesthetic agents is paramount. There are two potentially increased risks related to the continuation of SNRIs through the perioperative period: intraoperative bleeding and serotonin syndrome. SNRIs have some off-label uses, more new indications, and ever-increasing new applications in perioperative practice. This article aims to review the commonly prescribed serotonin-norepinephrine reuptake inhibitors and the current clinical evidence regarding their considerations in perioperative anesthesia and analgesia.

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Fentanyl versus tramadol with levobupivacaine for combined spinal-epidural analgesia in labor

Cited by 9 publications

References 16 publications

Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia

Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia

Evaluatıon Of Anaesthetic And Analgesic Effects Of Intrathecal Tramadol Vs Fentanyl Administration

New Serotonin-Norepinephrine Reuptake Inhibitors and Their Anesthetic and Analgesic Considerations

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