Tramadol and Beta-Cyclodextrin Piroxicam: Effective Multimodal Balanced Analgesia for the Intraand Postoperative Period: Effective Multimodal Balanced Analgesia for the Intra-and Posttoperative Period. Issue 3 (May 1997)

• Record Type: Journal Article
• Authors: Lauretti, G. R.; Mattos, A. L.; Lima, I. C. P. R.
• Is Part Of: Regional anesthesia. Volume 22:Issue 3(1997)
• Page Start: 243
• Page End: 248
• Publication Date: 1997-05
• Subjects: tramadol -- beta-cyclodextrin piroxicam -- perioperative analgesia; Conduction anesthesia -- Periodicals; Pain medicine -- Periodicals; 617.964
• DOI: 10.1136/rapm-00115550-199722030-00009
• Languages: English
• ISSNs: 0146-521X

Abstract

Abstract : Background and Objectives: This study was conducted to evaluate the analgesic efficacy of tramadol, an analgesic with both opioid and nonopioid actions (norepinephrine and serotonin pathways), with beta-cyclodextrin piroxicam, a nonsteroidal antiinflammatory drug, in the perioperative setting. Methods: The study population consisted of 48 patients scheduled for minor abdominal procedures, who were assigned to one of four groups of 12 patients each. The premedication was either a placebo tablet or a 192.1-mg beta-cyclodextrin piroxicam tablet, administered orally 30-40 minutes before anesthesia induction. After intravenous administration of tramadol 1.5 mg/kg, anesthesia was induced with an intravenous loading dose of propofol. Anesthesia was maintained an intravenous infusion of propofol at 6-12 mg/kg/h plus either saline or tramadol at 1.2 mg/kg/h, atracurium, and a 2:1 nitrous oxide-oxygen mixture. The control group received a placebo tablet and an infusion of saline with propofol for anesthesia maintenance; the tramadol group received a placebo tablet and a continuous tramadol-propofol infusion; the betacyclodextrin piroxicam (BCP) group received a BCP tablet and a continuous saline-propofol infusion; and the beta-cyclodextrin piroxicam-tramadol (BCPT) group received beta-cyclodextrin piroxicam and a continuous tramadol-propofol infusion. Results: The relative propofol consumption by the four groups was control = BCP ( P > .05) >tramadol ( P < .001) > B-CPT ( P < .0002). The time for analgesic rescue decreased in the order BCPT > BCP ( P < .0002) = tramadol > control ( P < .001). The degree of sedation and the visual analog scores 10-cm scale at the time patients requested rescue analgesics were similar among the groups ( P > .05). Conclusions: The combination of tramadol and beta-cyclodextrin piroxicam provided better perioperative analgesia than tramadol alone.