Postoperative Patient-Controlled Analgesia with Tramadol: Analgesic Efficacy and Minimum Effective Concentrations

Lehmann, K. A.; Kratzenberg, Ulrich; Schroeder-Bark, Barbara; Horrichs-Haermeyer, G.

doi:10.1097/00002508-199009000-00008

Cited by 184 publications

(99 citation statements)

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“…Although the minimum effective plasma concentration of tramadol for dogs has not been reported, it should be lower than 332 ng/ml for tramadol judging from the result of the present study. In humans, it was reported that the minimum effective plasma concentrations of tramadol was 287.7 ng/ml [16]. Giorgi et al [6] reported that the minimum effective plasma concentration of tramadol as calculated for humans had been maintained for about 6-7 hr following a single IV administration of 4 mg/kg tramadol in dogs.…”

Section: Discussionmentioning

confidence: 99%

Effects of a Single Bolus Intravenous Dose of Tramadol on Minimum Alveolar Concentration (MAC) of Sevoflurane in Dogs

Itami

Kawase

Tamaru

et al. 2013

The Journal of Veterinary Medical Science

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ABSTRACT. Tramadol is an atypical opioid analgesic widely used in small animal practice. This study was designed to determine the effect of a single intravenous (IV) dose of tramadol on the minimum alveolar concentration (MAC) of sevoflurane in dogs. Six beagle dogs were anesthetized twice to determine the sevoflurane MAC with or without an administration of tramadol (4 mg/kg, IV) at 7 days interval. The sevoflurane MAC was determined using a tail clamp method in each dog ventilated with positive pressure ventilation. The tramadol administration produced a significant reduction in the sevoflurane MAC by 22.3 ± 12.2% (1.44 ± 0.28% with tramadol versus 1.86 ± 0.30% without tramadol, P=0.010). This MAC reduction had been determined from 122 ± 19 to 180 ± 41 min following the tramadol administration. During this period, the plasma concentrations of tramadol and its metabolite, O-desmethyltramadol (M1), decreased from 429 ± 64 to 332 ± 55 ng/ml and from 136 ± 24 to 114 ± 68 ng/ml, respectively, but these changes were not statistically significant. There was no significant difference in heart rate, mean arterial blood pressure and SpO 2 between the control and tramadol treatment. The dogs that received tramadol treatment sometimes breathed spontaneously. Therefore, their respiratory rates significantly increased, and PETCO 2 decreased during the MAC determination. In conclusion, the single IV dose of tramadol produced a significant reduction in the sevoflurane MAC in dogs.

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Section: Discussionmentioning

confidence: 99%

Effects of a Single Bolus Intravenous Dose of Tramadol on Minimum Alveolar Concentration (MAC) of Sevoflurane in Dogs

Itami

Kawase

Tamaru

et al. 2013

The Journal of Veterinary Medical Science

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“…17 It has been reported that mean cumulative PCA demands and PCA morphine consumption in the first four hours after laparoscopic cholecystectomy were 50 and 10.4 mg, respectively, is Pain after laparoscopy has been reviewed recently by Alexander. 19 Lehmann et al 4 reported that the average PCA tramadol consumption (after a loading dose of 97.5 • 42.3 mg) was 160 • 99.5 mg over 20.5 • 4.8 hr in patients recovering from major orthopaedic or gynaecological operations. In this study, the cumulative PCA consumption in 24 hr was 111 • 93 and 7.5 • 6.6 mg of tramadol and morphine, respectively.…”

Section: Part 2: Postoperative Analgesiamentioning

confidence: 99%

“…In addition, analgesic tolerance has not been a serious problem during repeated administration, and neither psychological dependence nor euphoric effects are observed in long-term clinical trials. 4 Although several studies have documented the efficacy of tramadol for treating pain after different surgical procedures, 3-7 none has looked at its efficacy as an intraoperative analgesic in comparison with traditional opioids. It has been suggested that tramadol is unsuitable for intraoperative use because of the fear of intraoperative lightening of anaesthesia, when tramadol is used as a part of(and not added to) an anaesthetic regimen.…”

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confidence: 99%

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

et al. 1998

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Purpo~: To compare the efficacy of tramadol and morphine for intra-and postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Methods: In a prospective, randomized, double-blind study 100 patients were allocated randomly into two groups. Ten minutes before induction of anaesthesia, patients in group I received 100 mg tramadol and those in group 2 Anaesthesia was induced with 5 mg.kg-thiopental and was maintained with 0 2, N20 received I0 mg morphine iv. plus isoflurane with additional doses of tramadol or morphine as decided by the attending anaesthetist. PostopeFatively, patients in group I and group 2 received tramadol and morphine, respectively, from a patient-controlled analgesia (PC.A) device. Pain, analgesic consumption, vital signs and side effects were recorded postoperatively for 24 hr. l~.~lts: Intraoperative consumption of tramadol and morphine were 137 _+ 37 and 12.2 + 3 mg, respectively. Compared with morphine, patients receiving tramadol had higher blood pressures and required greater mean ET~s o to control haemodynamic variables (P < 0.05). Postoperatively, there were no differences in observer pain score or wsual analogue pain score during the first 24 hr between groups except at 30, 45, and 90 min where patients in the tramadol group reported higher pain scores (P < 0.05). The cumulative, 24 hr PCA consumption was I 11 _+ 93 and 7.5 ---6.6 mg oftramadol and morphine, respectively. Condmiom: There was no difference between the use of tramadol and morphine to treat pain after laparoscopic cholecystectomy from 90 min after the end of surgery. Morphine was more effective than tramadol as an intraoperative analgesic.

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“…Pharmacokinetic and pharmacodynamic studies in humans have demonstrated that the analgesic effects of tramadol result mainly from the actions of the (+) M1 enantiomer 21,22 .…”

Section: Discussionmentioning

confidence: 99%

A comparison of extradural tramadol and extradural morphine for postoperative analgesia in female dogs undergoing ovariohysterectomy

et al. 2012

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PURPOSE: To compare the postoperative analgesic effects of the extradural tramadol or morphine in female dogs undergoing ovariohysterectomy. METHODS: Sixteen female dogs were randomly assigned to two groups of eight animals each and received morphine (0.1mg kg-1 M group) or tramadol (2mg kg-1 T group). The pre-anesthetic medication was intravenously (iv) acepromazine (0.05mg kg-1). Anesthesia was induced with propofol (4mg kg-1iv) and maintained with isoflurane. The degree of analgesia was evaluated using a numerical rating scale that included physiologic and behavior variables. Dogs were scored at one, three, six and 12 hours after surgery by one blinded observer. Dogs were treated with morphine (0.5mg kg-1) if their scores were >6. Serum cortisol was measured before the pre-anesthetic medication was administered (basal), at the time of the ovarian pedicle clamping (T0), and at 1 (T1), 6 (T6) and 12 (T12) hours postoperative. RESULTS: The pain score did not differ between morphine and tramadol treatments. Rescue analgesia was administered to one dog in the T treatment group. Serum cortisol did not differ between treatments. CONCLUSION: The extradural administration of morphine or tramadol is a safe and effective method of inducing analgesia in female dogs undergoing ovariohyterectomy.

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Postoperative Patient-Controlled Analgesia with Tramadol: Analgesic Efficacy and Minimum Effective Concentrations

Cited by 184 publications

References 0 publications

Effects of a Single Bolus Intravenous Dose of Tramadol on Minimum Alveolar Concentration (MAC) of Sevoflurane in Dogs

Effects of a Single Bolus Intravenous Dose of Tramadol on Minimum Alveolar Concentration (MAC) of Sevoflurane in Dogs

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

A comparison of extradural tramadol and extradural morphine for postoperative analgesia in female dogs undergoing ovariohysterectomy

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