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

Abstract

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-

Reviews, systematic reviews and Anaesthesia

“…Such sequential methods can provide information on when firm evidence is reached in a cumulative meta-analysis, and can also provide an early clue to the lack of presence of a clinical effect. Finally, the systematic review can cast light on other aspects of practice; within Anaesthesia we have recently published a systematic review with meta-regression [32], a review of the interaction between ondansetron and tramadol [33], and case reports and series of cranial nerve injuries with supraglottic airways [34]. Manipulation of the existing dataset from a systematic review also helped confirm a recent case of research fraud [35].…”

Investigation of Activity of Dexketoprofen Trometamol for Postoperative Analgesia in Lower Limb Orthopaedic Surgery

“…Tüm hastalara tramadol HCl uygulaması öncesi profilaktik olarak antiemetik uygulanması bulantı / kusma insidansını çok düşürmektedir. 29 Tramadol HCl'nin yükleme dozunun 5 dk süresince yapılma-sının ve bolus dozlarının 2 dk süresince uygulanmasının bulantı kusmayı azaltacağı bildirilmek tedir. 30 Hasta kontrollü tramadol uygulamasına IV diklofenak, lornoksikam ve deksketoprofen eklendiği çalışmada; sadece tramadol uygulanan gruba göre bulantı/kusma insidansının daha az olduğu saptanmış ve bu durum kombine tedavinin düşük ağrı skoru, daha az tramadol kullanımı ve meperidin tüketimini azaltmasına bağlanmıştır.…”

Toward standardized reporting of drug interactions: the READI checklist for anecdotal reports

“…Guidelines have been developed for performing systematic reviews of adverse drug reactions [66], but I know of no guidelines for reporting the results of such studies and none in relation to drug interactions, although reviews of drug-drug interactions occasionally appear [67,68], including teleoanalyses (i.e., analyses using combined data from different types of studies) [69,70]. Current general guidelines for these types of studies (TABLE 1) can be used and adapted where necessary.…”