Role of tramadol in reducing pain on propofol injection

Department of Anaesthesia, National University Hospital, Singapore.
Singapore medical journal (Impact Factor: 0.6). 05/2001; 42(5):193-5.
Source: PubMed


Propofol is frequently associated with pain on injection. We evaluated the effect of tramadol in a randomised, double-blind study using a tourniquet venous retention technique. Normal saline placebo was given intravenously to patients in Group 1 (n = 30),tramadol 50 mg to Group 2 (n = 30), and lignocaine 50 mg to Group 3 (n = 30). The venous retention of drugs was maintained for 1 minute, followed by tourniquet release and intravenous administration of propofol. Pain assessment was made immediately after propofol injection. There was a significant reduction in the incidence of pain associated with propofol administration in patients pretreated with lignocaine and tramadol (P < 0.05). In addition, pretreatment with tramadol was as effective as lignocaine in reducing pain on propofol injection.

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    • "The most common side effects of propofol are local pain on injection site as well as blood pressure decline (1). The incidence of propofol pain varies from 28 % to 90% in different studies (2), with a single report of 85% in children (3). The pain can be ranked as severe, an estimate of 5.6 ± 2.3 on VAS pain evaluation system (4). "
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    ABSTRACT: Propofol is one of common anesthetic drugs used in anesthesia. The most common side effects of propofol are local pain. Pretreatment with lidocaine can reduce propofol injection pain. The aim of the present study was to assess and compare the efficiency of lidocaine 0.4% and 2% in reducing the incidence and severity of propofol injection pain. This was a double blind prospective clinical trial on children 4-8 years old with class ASA I and II candidates who were referred to Dr. Shaikh Hospital in Mashhad for elective surgery. Sample size calculated 50 patients in each groups based on pilot study. 100 children's were randomly divided equally in two groups, who were injected with lidocaine solutions 2% and 0.4% respectively. patient's pain evaluation based on VSD (verbal descriptor scale) and NRS (Numeric Rating Scale) using patient's verbal reaction and behavior namely fretting, hand drag and tearing. The collated data was analyzed. There was nosignificant difference as to the first three variables (age, gender and weight P > 0.2). The significant difference regarding pain experience in both groups was noteworthy (P > 0.2). Most of the studies compared lidocaine with other drugs or its efficiency at different doses. Our study is different in that we applied a constant dose of lidocaine in various volumes and concentration. This result shows that lidocaine with the same does but lower concentration and higher volume is more effective in preventing propofol injection pain. Using diluted lidocaine with the dosage of 1 mg/kg and a concentration of 0.4% is an effective way to relieve pain caused by propofol injection in children.
    03/2014; 16(3):e16099. DOI:10.5812/ircmj.16099
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    • "Various techniques have been used in different studies in order to decrease the pain of propofol injection, including diluting propofol, cooling or heating, using larger vessels for injection or adding lidocaine. Also, The drugs which have been studied to decrease the pain included different doses of lidocaine (5-9), NSAIDs (5), metoclopramide (6), opiates such as morphine, meperidine, fentanyl (7) tramadol (2), thiopental sodium (4), nafamostatmesilate (10), ketamine (8, 11), ondansetron (12) granisetron (13, 14) magnesium sulfate (8, 15-18) and paracetamol (9, 19), have been associated with different results. "
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    ABSTRACT: Propofol is a most widely used intravenous anesthetic drug. One of its most common complications is the pain upon injection; therefore, different methods, with various effects, have been proposed in order to alleviate the pain. This study investigates the effects of paracetamol, ondansetron, granisetron, magnesium sulfate and lidocaine drugs on reducing the pain of propofol injection during anesthetic induction. Also, the hemodynamic changes will be analyzed. This is an interventional study containing 336 patients underwent elective orthopedic surgeries in Educational Hospitals of Mashhad University, using systematic sampling, the patients were divided into six groups. A 20-gauge needle was inserted into a venous vessel in the back of the hand and 100 cc of Ringer serum was injected into the vein, which was applied proximal to the injection site. Afterwards, paracetamol 2 mg/kg (group p), magnesium sulfate 2 mmol (group M), ondansetron 4 mg (group O), granisetron 2 mg (group G), lidocaine 40 mg (group L) and 5 cc saline (group S) were injected into the vessel, after 60 seconds, the tourniquet was opened. One quarter of the total dose of propofol (2.5 mg/kg) was injected with a flow rate of 4 mg/sec and then the injection pain was measured. Finally, the fentanyl (2 µg/kg), atracurium 0.5 mg/kg, and the remaining dose of propofol were injected and the vital signs were recorded before the administration of propofol and 1, 3, 5 and 10 minutes after the propofol injection. The six groups did not significantly differ, regarding their gender, weight or age. Propofol injection pain was less in L and G groups, in comparison with the others (P ≤ 0.001). By analyzing the hemodynamic changes, it was observed that the least amount of change in mean arterial pressure was observed in the paracetamol group. The reduction of propofol injection pain was observed by using medications (in comparison with normal saline), but it was more significant in groups G and L. Moreover, Hypotension was higher in groups S and G and it was lessened in group P.
    03/2014; 16(3):e16086. DOI:10.5812/ircmj.16086
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    ABSTRACT: Tramadol is a centrally acting analgesic with μ-opioid and monoaminergic agonist effect. Ten healthy adult dogs were studied (mean ± SEM body weight 17.3 ± 3.8 kg), premedicated with acepromazine (0.05 mg/kg, IM), induced with thiopental (10 mg/kg, IV) and maintained under anesthesia with halothane in oxygen. Twenty minutes after starting halothane anesthesia, tramadol (1.0 mg/kg in 0.22 ml/kg of sterile water) was administered epidurally at the lumbo-sacral space. Surgery began 15 minutes later. Pulse and respiratory rates, systolic, mean and diastolic arterial blood pressure, and pulse oximetry were measu red before premedication (baseline), and at fixed intervals after anesthesia induction. Arterial pH, PaO 2, PaCO2, HCO3 - , and SaO2 were measured at baseline, immediately before the epidural, and 60, 120, 240 and 360 minutes thereafter. Post-operative analges ia was evaluated for four hours using a scoring system. Statistically significant decrease in arterial blood pressure was observed following anesthetic induction. The PaCO 2 increased significantly from baseline at 60 minutes after epidural tramadol. The remaining variables were not significantly different from baseline values. No variables were significantly different from value s obtained immediately before tramadol administration. Intraoperative antinociception was considered adequate, with satisfactory post-operative analgesia for four hours. In conclusion, epidural tramadol seems to produce satisfactory antinociception and analgesia without causing clinically significant hemodynamic and respiratory depression in healthy dogs undergoing stifle
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