Intravenous Tramadol Research Articles

Prospective randomised study for comparison of intravenous tramadol and intravenous dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia

Prospective randomised study for comparison of intravenous tramadol and intravenous dexmedetomidine for the control of intraoperative shivering under spinal anaesthesia

Efficacy of intravenous Tramadol in prevention of catheter-related bladder discomfort in upper urinary tract surgery

Introductions: Catheter-related bladder discomfort (CRBD) is common in patients with urinary catheterization. Centrally acting intravenous opioid like Tramadol inhibits detrusor activity and incidence of CRBD. Present study aims to analyze efficacy of intravenous (IV) Tramadol in prevention of CRBD in patients undergoing upper urinary tract surgery. 
 Methods: Adult patients undergoing elective open upper urinary tract surgeries at Bir Hospital, National Academy of Medical Sciences (NAMS), Nepal, over a period of six months, requiring urinary catheterization were randomly divided into Control (C) and Tramadol (T) groups. After general anesthesia, patients in T-group received IV Tramadol 1.0 mg/kg and C-group received normal saline 30 minutes before extubation. In post-operative ward, CRBD was graded as mild, moderate or severe at 0, 1, 2 and 6 hours. Post-operative Ramsay sedation score and nausea vomiting were compared in two groups. 
 Results: There were total 70 patients, 35 in each of groups-T and C. Incidence of CRBD in T-group was significantly low compared to the C-group at all points of evaluation (p<0.05). Postoperative sedation score, analgesic requirement and nausea vomiting were not significantly different in two groups. 
 Conclusions: Intravenous Tramadol administered before extubation in upper urinary tract surgery reduces the incidence of CRBD.

Postoperative pain management for circumcision; Comparison of frequently used methods.

Objective:To determine the ideal method for postoperative pain management after circumcision by comparing the most frequently used different methods like; dorsal penile block, caudal epidural block, subcutaneous ring block, intravenous paracetamol and intravenous tramadol HCl.Methods:Between May 1st 2015 to May 1st 2016, 500 children between 2-10 year old were circumcised at the department of pediatric surgery of Istanbul Medipol University Health Care Practice & Research Center Sefakoy Hospital. Five groups were formed according to postoperative analgesia methods which were planned to be compared; Group-I. penile block, Group-II. Caudal epidural block, Group-III. subcutaneous ring block, Group-IV as intravenous paracetamol and Group-V as intravenous tramadol HCl. In order to evaluate the postoperative pain levels of children, Children’s Hospital Eastern Ontario Pain Scale (CHEOPS) was filled at 30, 60, 120, 180 minutes after circumcision by a researcher who does not know which method was applied.Results:No significant difference is found between the groups (p>0.05). In the statistical analysis, no significant difference was found in the effect of analgesia methods on CHEOPS scores between 30, 60, 120 and 180 minutes (p>0.05). In parallel with this result, no significant difference was found in the effect of heart beat rates and respiration rate averages between 30, 60, 120 and 180 minutes (p>0.05).Conclusion:It has been shown that none of the five method has any superiority in reducing pain after circumcision and that all five methods can be used. However, we think that side effects of regional anesthesia and systemic analgesic applications should not be ignored.

Comparing the Pharmacokinetics of 2 Novel Intravenous Tramadol Dosing Regimens to Oral Tramadol: A Randomized 3‐Arm Crossover Study

Tramadol is a dual‐mechanism (opiate and monoamine reuptake inhibition) analgesic. Intravenous (IV) tramadol has been widely prescribed outside the United States. However, there have not been studies comparing the pharmacokinetics (PK) of IV dosing regimens to that of oral tramadol. In this phase 1, open‐label, single investigational center, 3‐treatment, 3‐period, multidose crossover study, we compared 2 novel IV dosing regimens (IV tramadol 75 mg and IV tramadol 50 mg) to oral tramadol 100 mg given every 6 hours (the highest approved oral dosage in the United States) Compared to the oral regimen, IV tramadol 50 mg administered at hours 0, 2, and 4 and every 4 hours thereafter reached initial tramadol peak serum concentration (Cmax) more rapidly, while resulting in similar overall steady‐state Cmax and area under the plasma concentration–time curve. IV tramadol 75 mg administered at hours 0, 3, and 6 and every 6 hours thereafter had higher Cmax and greater fluctuation in peak to trough tramadol concentration. The primary metabolite M1 (a potent μ agonist) had lower area under the plasma concentration–time curve and Cmax for both IV regimens than for the oral regimen. IV tramadol at both doses was well tolerated, with adverse event profiles consistent with the known pharmacological effects of tramadol. IV tramadol 50 mg is now in phase 3 development in patients with postsurgical pain.

Risk factors for adverse events in patients administered intravenous tramadol hydrochloride in Emergency Department

INTRODUCTION: The aim of the present study was to assess the adverse events developing in patients treating with intravenous(iv) tramadol to provide moderate to severe pain control in emergency department (ED) and to investigate the association of these adverse events with age, sex and vital signs and to compose a set of rules for the identification of patients in the risk group. MATERIAL AND METHODS: In this prospective cohort study, patients older than 18 years, admitted to ED during a 1-year period and administered iv tramadol were included in a secondary care public hospital. Information about age, sex, vital signs and adverse events were recorded. Patients defined as group 1 or group 2 with respect to adverse event development status and the groups were compared in terms of age, sex and vital signs. RESULTS: A total of 408 patients were included in the study. Adverse events ratio after treatment was 21.1%. Adverse events were nausea, dizziness and vomiting. The age and the pulse rate per minute of the patients in group 1 were found to be higher and systolic blood pressure (SBP) was found to be lower than the patients in group 2. CONCLUSİONS: The risk of adverse events development is higher in patients who are hypotensive, tachycardic and older than 56 years. Multicenter, prospective studies with larger patient groups are needed to support our results.

Comparison of meperidine, tramadol and fentanyl for post-spinal shivering prevention during cesarean delivery: A double-blind randomized controlled trial.

To assess the effects of intravenously administered meperidine, fentanyl and tramadol in reducing the incidence, onset time and severity of the shivering response in parturients during cesarean delivery under spinal anesthesia. Secondary outcomes included patient satisfaction and sedation scores. After Ethics board approval and informed written consent, 350 parturients (ASA physical status I or II), between 20 and 40 years of age, undergoing emergency or elective cesarean delivery under spinal anesthesia were recruited. Parturients were then randomly allocated to seven study groups: normal saline (control), low-dose meperidine (0.5 mg/kg), high-dose meperidine (0.75 mg/kg), low-dose fentanyl (0.5 mcg/kg), high-dose fentanyl (0.75 mcg/kg), low-dose tramadol (0.5 mg/kg) and high-dose tramadol (0.75 mg/kg). The incidence, onset time and severity of shivering, along with patient satisfaction and sedation scores were measured. All study drugs showed significant reduction in incidence, onset time and severity of shivering and greater satisfaction scores compared to the control group (P < 0.01). Within each drug class, no significant differences in shivering were found between the high-dose and low-dose groups. Among study drugs, low-dose tramadol was superior due to shivering prevention and significantly reduced sedation. Intravenously administered meperidine, fentanyl and tramadol reduce shivering incidence, onset time and severity in parturients undergoing cesarean delivery following spinal anesthesia. Importantly, low-dose intravenous tramadol (0.5 mg/kg) allowed shivering prevention and low sedation scores, thereby offering greater parturient satisfaction and better maternal-newborn bonding.

Effect of Tramadol Pretreatment on Sufentanil-Induced Cough

To investigate the effect of tramadol pretreatment on the incidence and severity of sufentanil-induced cough. Randomized controlled trial. Adults of both genders (N=304; 18 to 65years old, American Society of Anesthesiologists physical status I to II), scheduled for elective surgery, were randomized into two groups (n=152): intravenous administration of tramadol 1mg/kg (group T) or normal saline (group C). Then sufentanil bolus 0.3mcg/kg was administered intravenously in 5seconds. The incidence and severity of cough were observed for 1 minute. Mean arterial pressure, heart rate, nausea, vomiting, and truncal rigidity during induction were also recorded. Patient characteristics were similar between the two groups. The incidence of cough was significantly lower in group T when compared with group C (7.9% vs 18.4%, P<.05); there were nine patients coughing severely in group C, whereas no severe cough occurred in group T (P<.05). The mean arterial pressure, heart rate, and incidences of other side effects were comparable between the two groups. Pretreatment of intravenous tramadol 1mg/kg could be a clinically effective intervention for attenuating sufentanil-induced cough.

Comparative Study of the Analgesic Efficacy of Rectal Tramadol versus Intravenous Tramadol for Inguinal Hernia Repair Surgery

Comparative Study of the Analgesic Efficacy of Rectal Tramadol versus Intravenous Tramadol for Inguinal Hernia Repair Surgery

A comparative study to ascertain the efficacy of intravenous dexmedetomidine versus intravenous tramadol to prevent post-operative shivering after laparoscopic surgery

Background: Shivering is commonly encountered both after regional and general anaesthesia (GA) with a little higher incidence in patients receiving GA. The aim of study was to compare the effectiveness of dexmedetomidine and tramadol in decreasing postoperative shivering in patients undergoing laparoscopic surgery.Methods: Total 120 patients were included in this study. In order to get a 5% level of significance and 80% power number of patients required in each group was 40, with a total of 120 patients. Randomization of groups was done based on closed envelope method. Patients were allocated into three groups group I, II and III of 40 patients each. Patients in group I and group II were administered 0.75 μg/kg of dexmedetomidine and 1.5 mg /kg of tramadol in 100 ml NS respectively half a before extubation, while patients in group III did not receive any pharmacological intervention.Results: All three groups were comparable regarding distribution of age, gender, ASA grade and temperature at beginning and end of surgery and were non-significant.Conclusions: Dexmedetomidine seems to possess anti-shivering properties and was found to reduce the occurrence of shivering in patients undergoing general anaesthesia with minimal side effects although its anti-shivering effect was not superior to tramadol.

Bupivacaine infiltration in children for postoperative analgesia after tonsillectomy: A randomised controlled trial.

Adenotonsillectomy is a frequently performed procedure in paediatric day-case surgery. Postoperative pain can be significant and standard analgesia protocols are often insufficient. Our primary objective was to investigate if infiltration of the peritonsillar space with bupivacaine would reduce the need for postoperative opioids compared with pre-emptive intravenous tramadol. A double-blind, randomised controlled trial. Ambulatory surgical day care centre, University Hospitals of Leuven, Belgium, from January 2012 to September 2016. Two hundred children, between 4 and 10 years old, undergoing elective adenotonsillectomy were included in the study. Children were randomly allocated to receive either a bolus of 3 mg kg intravenous tramadol or infiltration of the tonsillar lodge with 5-ml bupivacaine 0.25%. Reasons for exclusion were American Society of Anesthesiologists classification greater than 2, allergies to the investigated products, psychomotor retardation, bleeding disorders and lack of proficiency in Flemish. The primary endpoint was the number of children in need of piritramide postoperatively. Secondary outcomes included the cumulative dose of postoperative piritramide, pain scores and the incidence of postoperative nausea and vomiting during the first 24 postoperative hours, time to discharge and adverse effects. The proportion of children in need of postoperative piritramide was significantly lower in the tramadol group than in children with peritonsillar infiltration (57 vs. 81%, P < 0.001). When in need of postoperative piritramide, the tramadol-group required a significantly lower dose (median [IQR] 0.7 [0.6 to 1] vs. 1 [0.6 to 1.5] mg, P < 0.007) and had lower pain scores during the first 60 min after surgery. There were no statistically significant differences in postoperative nausea and vomiting incidence, need for antiemetics or complications. Compared with peritonsillar infiltration, preemptive intravenous tramadol decreases the need for postoperative opioids after tonsillectomy in children without increasing the incidence of side effects. EudraCT 2011-005467-25.

A Randomized Double-Blind Study: Evulation of Comparing Intravenous Fentanyl with Intravenous Tramadol Administered to Patients with Pain Control Due to Urinary Stone Disease

A Randomized Double-Blind Study: Evulation of Comparing Intravenous Fentanyl with Intravenous Tramadol Administered to Patients with Pain Control Due to Urinary Stone Disease

Effectiveness of Prophylactic Use of Intravenous Ketamine, Dexmedetomidine and Tramadol for Prevention of Shivering After Spinal Anesthesia

Background: Shivering after spinal anesthesia is a common complication and can occur in as many as 40%-70% of patients after regional anesthesia. Present study was done with an aim to assess and evaluate the effectiveness of prophylactic use of intravenous (IV) ketamine, dexmedetomidine, and tramadol for prevention of shivering after spinal anesthesia. &nbsp;Subjects and Methods: Present study was conducted at tertiary care institute of Gujarat, India. The study was carried out in 160 patients and the participants were randomized into four groups of 40 patients each as&nbsp; Group A ‑ patients receiving ketamine 0.5 mg/kg intravenous (IV) diluted in 10 mL of normal saline (NS) given as IV infusion over 10 min&nbsp; Group B ‑ patients receiving tramadol 0.5 mg/kg diluted in 10 mL of NS given as IV infusion over 10 min, Group C ‑ patients receiving dexmedetomidine 0.5 mcg/kg diluted in 10 mL of NS given as IV infusion over 10 min, Group D ‑ patients receiving 10 mL of NS given as IV infusion over 10 min. Results: There was no statistically significant difference among mean age, gender, and the duration of surgery. There was statistically significant difference among the four groups, when overall shivering grades were compared. The overall sedation score, when compared among four groups was statistically significant. Conclusion: Dexmedetomidine is effective and comparably better than tramadol or ketamine in preventing shivering after spinal anesthesia. Apart from preventing shivering, dexmedetomidine offers other advantages in the form of sedation without any respiratory depression. However, with its use a watch should be kept on the fall hemodynamic parameters.

PREOPERATIVE INTRAVENOUS TRAMADOL FOR PERCUTANEOUS NEPHROSTOMY TO REDUCE INTRAOPERATIVE PAIN

Objective: To evaluate the effect of additional preoperative intravenous tramadol for reducing intraoperative pain. Material &amp; Methods: This study was a double blind randomized controlled study from April - June 2017 in Urology Department in Hasan Sadikin Hospital. Inclusion criteria were cervical cancer patients who were performed percutaneous nephrostomy. Exclusion criteria were patients with infection and pain before the procedure. Written informed consent was obtained from each patient and the study protocol was approved by the local human ethics committee. The subjects were randomly divided into 2 groups. Group A were given 100 ml dripped normal saline 1 hour before the procedure and intraoperative local anesthesia with lidocaine 2% and group B were given preoperative intravenous tramadol 100 mg dripped within 100 ml of normal saline 1 hour before the procedure and intraoperative lidocaine 2%. Visual Analogue Score (VAS) were used to evaluate the pain score. All calculation were done using SPSS version 20. Results: There were 60 cervical cancer patients who were performed percutaneous nephrostomy (29 patients in Group A and 31 patients in Group B). The mean age in group A was 48.86 ± 8.524 (years old) and the mean age in group B was 51.90 ± 6.76 (years old). The median VAS score in group A was 4, with the minimum score was 2.00, maximum score was 6.00. The median VAS score in group B was 2, with the minimum score was 0.00, maximum score was 4.00. In group A, 11 patients (18.3%) were mild pain, 16 patients (26.7%) were moderate pain, 2 patients (3.3%) were severe pain. In group B, 29 patients (48.3%) were mild pain, 2 patients (3.3%) were moderate pain, 0 patients (0.0%) were severe pain. Based on Mann-Whitney U test, there was a significant pain score reduction in group B compared to group A (p=0.0001). There were no significant differences in the prevalence or proportion of patients with nausea and vomiting in group A and B (10% and 12%, respectively). There were no other adverse events and other complications observed in both groups. Conclusion: Preoperative intravenous tramadol significantly reduced intraoperative pain in cervical patients who were performed percutaneous nephrostomy compare to those who were only given intraoperative local anesthesia.

A Randomized Controlled Trial of Intravenous Paracetamol and Intravenous Tramadol for Labour Analgesia

Background: Labour pain described as ‘the most horrible’ affects both physiological and psychological aspects of labour. Thus, the provision of labour analgesia is of paramount importance to better both maternal and neonatal outcomes. In our country, majority of obstetric services are in the hands of trained nurses and non-specialized doctors and thus awareness and acceptance of pain-relieving for women in labour virtually does not exist. Therefore, drugs like paracetamol and tramadol with advantage of easy availability, being inexpensive with no special technique of administration are a boon for labour analgesia. Objective: To compare the role of intravenous paracetamol versus intravenous tramadol as an intrapartum labour analgesic. Materials and methods: A total of 273 primigravidae with term gestation with singleton pregnancy with vertex presentation in active phase of labour with cervical dilatation ≥ 4cm with spontaneous onset of labour were taken who satisfied the inclusion and exclusion criteria of the study. Group P (141 women) and Group T (132 women) received 100 ml intravenous infusion containing 1 gram of paracetamol single dose and 100 mg of tramadol hydrochloride diluted in 100 ml normal saline over 15 minutes respectively. Visual Analogue scale (VAS) was used to assess pain intensity, before administering drug, after 1 and 3 hours of drug administration. The primary outcomes measured were difference in VAS score in both groups. The secondary outcomes analysed were mode of delivery, duration of labour, drug-delivery interval, maternal side effects and neonatal outcomes in terms of birth weight, APGAR scores and NICU admissions. Results: The mean VAS score decreased significantly to a greater extent in group P than group T and showed a significant statistical difference among both the groups (p < 0.001). In both the groups, the difference in the VAS score was statistically significant (p<0.05). The duration of labour was statistically shorter in group P (p< 0.0001). The participants in group T had more incidence of maternal side-effects and 7 NICU admission than in paracetamol group. Conclusion: Intravenous paracetamol with better analgesic efficacy, shorter duration of labour and fewer maternal side effects is a more effective labour analgesic than tramadol.

Comparative Study of Intravenous Butorphanol and Intravenous Tramadol for Control of Intra-operative Shivering Under Spinal Anesthesia

Comparative Study of Intravenous Butorphanol and Intravenous Tramadol for Control of Intra-operative Shivering Under Spinal Anesthesia

Comparison of Efficacy of Intravenous Paracetamol Versus Intravenous Tramadol for Postoperative Analgesia in Surgeries under General Anaesthesia

Comparison of Efficacy of Intravenous Paracetamol Versus Intravenous Tramadol for Postoperative Analgesia in Surgeries under General Anaesthesia

Analgesic Efficacy of Intravenous Paracetamol Versus Intravenous Tramadol after Cesarean Section

Analgesic Efficacy of Intravenous Paracetamol Versus Intravenous Tramadol after Cesarean Section

Comparison of Intravenous Ondansetron and Tramadol for Control of Shivering during Spinal Anaesthesia: A Prospective, Observer Blind Study

Comparison of Intravenous Ondansetron and Tramadol for Control of Shivering during Spinal Anaesthesia: A Prospective, Observer Blind Study

Patient-controlled intravenous tramadol versus patient-controlled intravenous hydromorphone for analgesia after secondary cesarean delivery: a randomized controlled trial to compare analgesic, anti-anxiety and anti-depression effects.

IntroductionThis study aimed to compare the postoperative analgesic effects of tramadol and hydromorphone for secondary cesarean delivery (CD) as well as their anti-anxiety and anti-depression properties.MethodsA total of 106 patients receiving secondary CD under spinal anesthesia were randomly allocated to the tramadol group (n=53) and the hydromorphone group (n=53). Each group received patient-controlled intravenous analgesia using flurbiprofen 4 mg/kg combined with tramadol (4 mg/kg) or hydromorphone (0.04 mg/kg) immediately after the surgery. Postoperative pain numerical rating scale (NRS) for incision and visceral pain, hospital anxiety and depression scale (HADS), early walking time and length of hospital stay were assessed.ResultsPatients in the tramadol and hydromorphone groups exhibited equivalent incision pain NRS at different time points (P>0.05). Visceral pain in the tramadol group was higher than that in the hydromorphone group at postoperative 4 hours (2.9 [1.2] vs 2.3 [1.4], P=0.011) and 8 hours (2.4 [1.1] vs 1.8 [1.1], P=0.028). One week after the surgery, the patients in the tramadol group, as compared to the hydromorphone group, had lower anxiety scores (1.9 [3.5] vs 3.6 [4.1], P=0.033) and depression scores (0.8 [1.3] vs 2.7 [4.1], P=0.023). In addition, early walking time (25.3 [7.0] hours vs 29.3 [9.6] hours, P=0.016) and length of hospital stay (2.9 [0.8] days vs 3.3 [0.8] days, P= 0.008) after the surgery in the tramadol group were less than those in the hydromorphone group.ConclusionPostoperative intravenous analgesia with tramadol or hydromorphone for secondary CD provides comparable analgesic effects on incision pain. Tramadol is less effective in controlling visceral pain compared to hydromorphone. However, tramadol can help to alleviate anxiety and depression in the early postpartum period, improve patients’ early mobilization and shorten their hospital stay.Clinical trial number and registry URLNo: ChiCTR-IIR-17011043; URL: www.chictr.org.cn.

Intravenous Diclofenac vs. Tramadol infusion for Post-operative Pain Management: A Randomized Trial

Purpose: The study was conducted to compare the analgesic and adverse effect profiles of intravenous infusion of Tramadol and Diclofenac in post-operative pain management.&#x0D; Method: Cancer patients undergoing major surgery were prospectively randomized into two groups of 35 and was entered into single blinded clinical trial. Patients in each arm received either Tramadol (Gr A) or Diclofenac Infusion (Voveran®) (Gr B) for first 48 hours after surgery. Pain intensity was measured based on a 10 point Verbal Rating Scale (VRS). VRS was obtained at 6, 12, 18, 24, 30, 36, 42 and 48 hrs post-operatively.&#x0D; Result: The mean age was 56.3 and 49.5 years in Gr A and B, respectively (p=.056). Mean length of incision was 16.46 cm and 18.23 cm in Gr A and B, respectively (p=.1). On 0 post-operative day, 14 patients in Gr A and 6 patients in Gr B required accessory analgesics (p=.18). On 1st post-operative day, 2 patients in Gr A and 1 patient in Gr B required accessory analgesics (p=.6). One patient on Tramadol group had nausea post-operatively. Average cost was 471.73 and 227.80 Nepali rupees in Gr A and Gr B, respectively (p=.032).&#x0D; Conclusion: Intravenous infusion of Diclofenac should be considered as a safe and cheaper alternative to Tramadol infusion for pain management after major surgical oncological procedures.