Tramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study.

Hdl Handle:
http://hdl.handle.net/10147/208935
Title:
Tramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study.
Authors:
Mannion, S; O'Callaghan, S; Murphy, D B; Shorten, G D
Affiliation:
Department of Anaesthesia and Intensive Care, Cork University Hospital,, University College Cork, Cork, Ireland. mannionstephen@hotmail.com
Citation:
Br J Anaesth. 2005 Mar;94(3):352-6. Epub 2004 Dec 17.
Journal:
British journal of anaesthesia
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/208935
DOI:
10.1093/bja/aei057
PubMed ID:
15608044
Abstract:
BACKGROUND: Tramadol has been administered peripherally to prolong analgesia after brachial plexus and neuraxial blocks. Our aim was to evaluate the systemic and perineural effects of tramadol as an analgesic adjunct to psoas compartment block (PCB) with levobupivacaine. METHODS: In a randomized, prospective, double-blinded trial, 60 patients (ASA I-III), aged 49-88 yr, undergoing primary total hip or knee arthroplasty underwent PCB and subsequent bupivacaine spinal anaesthesia. Patients were randomized into three groups. Each patient received PCB with levobupivacaine 0.5%, 0.4 ml kg(-1). The control group (group L, n=21) received i.v. saline, the systemic tramadol group (group IT, n=19) received i.v. tramadol 1.5 mg kg(-1) and the perineural tramadol group (group T, n=20) received i.v. saline and PCB with tramadol 1.5 mg kg(-1). Postoperatively patients received regular paracetamol 6-hourly and diclofenac sodium 12-hourly. Time to first morphine analgesia, 24-hour morphine consumption, sensory block, pain and sedation scores and haemodynamic parameters were recorded. RESULTS: Time (h) to first morphine analgesia was similar in the three groups [mean (SD)]: group L, 11.2 (6.6); group T, 14.5 (8.0); group IT, 14.6 (6.8); P=0.35. Twenty-four-hour cumulative morphine (mg) consumption was also similar in the three groups [group L, 21.9 (10.1); group T, 19.8 (6.7), group IT, 16.5 (9.5)], as were durations of sensory and motor block. There were no differences in the incidence of adverse effects except that patients in group IT were more sedated at 14 h than group L (P=0.02). CONCLUSION: We conclude that our data do not support a clinically important local anaesthetic or peripheral analgesic effect of tramadol as adjunct to PCB with levobupivacaine 0.5%.
Language:
eng
MeSH:
Aged; Aged, 80 and over; *Analgesics, Opioid/administration & dosage; *Anesthetics, Local; Arthroplasty, Replacement, Hip; Arthroplasty, Replacement, Knee; *Bupivacaine/analogs & derivatives; Double-Blind Method; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Morphine/administration & dosage; Nerve Block/*methods; Pain Measurement/methods; Pain, Postoperative/drug therapy/prevention & control; Prospective Studies; Psoas Muscles/innervation; *Tramadol
ISSN:
0007-0912 (Print); 0007-0912 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorMannion, Sen_GB
dc.contributor.authorO'Callaghan, Sen_GB
dc.contributor.authorMurphy, D Ben_GB
dc.contributor.authorShorten, G Den_GB
dc.date.accessioned2012-02-03T15:07:51Z-
dc.date.available2012-02-03T15:07:51Z-
dc.date.issued2012-02-03T15:07:51Z-
dc.identifier.citationBr J Anaesth. 2005 Mar;94(3):352-6. Epub 2004 Dec 17.en_GB
dc.identifier.issn0007-0912 (Print)en_GB
dc.identifier.issn0007-0912 (Linking)en_GB
dc.identifier.pmid15608044en_GB
dc.identifier.doi10.1093/bja/aei057en_GB
dc.identifier.urihttp://hdl.handle.net/10147/208935-
dc.description.abstractBACKGROUND: Tramadol has been administered peripherally to prolong analgesia after brachial plexus and neuraxial blocks. Our aim was to evaluate the systemic and perineural effects of tramadol as an analgesic adjunct to psoas compartment block (PCB) with levobupivacaine. METHODS: In a randomized, prospective, double-blinded trial, 60 patients (ASA I-III), aged 49-88 yr, undergoing primary total hip or knee arthroplasty underwent PCB and subsequent bupivacaine spinal anaesthesia. Patients were randomized into three groups. Each patient received PCB with levobupivacaine 0.5%, 0.4 ml kg(-1). The control group (group L, n=21) received i.v. saline, the systemic tramadol group (group IT, n=19) received i.v. tramadol 1.5 mg kg(-1) and the perineural tramadol group (group T, n=20) received i.v. saline and PCB with tramadol 1.5 mg kg(-1). Postoperatively patients received regular paracetamol 6-hourly and diclofenac sodium 12-hourly. Time to first morphine analgesia, 24-hour morphine consumption, sensory block, pain and sedation scores and haemodynamic parameters were recorded. RESULTS: Time (h) to first morphine analgesia was similar in the three groups [mean (SD)]: group L, 11.2 (6.6); group T, 14.5 (8.0); group IT, 14.6 (6.8); P=0.35. Twenty-four-hour cumulative morphine (mg) consumption was also similar in the three groups [group L, 21.9 (10.1); group T, 19.8 (6.7), group IT, 16.5 (9.5)], as were durations of sensory and motor block. There were no differences in the incidence of adverse effects except that patients in group IT were more sedated at 14 h than group L (P=0.02). CONCLUSION: We conclude that our data do not support a clinically important local anaesthetic or peripheral analgesic effect of tramadol as adjunct to PCB with levobupivacaine 0.5%.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.mesh*Analgesics, Opioid/administration & dosageen_GB
dc.subject.mesh*Anesthetics, Localen_GB
dc.subject.meshArthroplasty, Replacement, Hipen_GB
dc.subject.meshArthroplasty, Replacement, Kneeen_GB
dc.subject.mesh*Bupivacaine/analogs & derivativesen_GB
dc.subject.meshDouble-Blind Methoden_GB
dc.subject.meshDrug Administration Scheduleen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMorphine/administration & dosageen_GB
dc.subject.meshNerve Block/*methodsen_GB
dc.subject.meshPain Measurement/methodsen_GB
dc.subject.meshPain, Postoperative/drug therapy/prevention & controlen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshPsoas Muscles/innervationen_GB
dc.subject.mesh*Tramadolen_GB
dc.titleTramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study.en_GB
dc.contributor.departmentDepartment of Anaesthesia and Intensive Care, Cork University Hospital,, University College Cork, Cork, Ireland. mannionstephen@hotmail.comen_GB
dc.identifier.journalBritish journal of anaesthesiaen_GB
dc.description.provinceMunster-
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