Slower intravenous tramadol administration can prevent nausea and vomiting and predict postoperative nausea and vomiting: a randomized controlled trial.

Objective: Nausea and vomiting are the most common complications in patients who use tramadol for analgesia. This study evaluated the risk of nausea and vomiting related to intravenous tramadol administration. Methods: In this study, 315 patients who received pre-analgesia before elective surgery were selected, and participants were divided into groups based on the Apfel risk assessment of nausea and vomiting, as follows: high risk (Apfel=4), medium risk (Apfel=2-3), and low-risk (Apfel=1). Tramadol (1.5 mg/kg) was administered intravenously over a duration of 1 min, 2 min, or 3 min before anaesthesia induction to observe preoperative nausea and vomiting reactions within 10 min. Results: In the low-risk group, the numeric rating scale for postoperative nausea scores and the incidence of nausea and vomiting were significantly lower in the 3-min group than those in the 1-min group, and the incidence of preoperative nausea and vomiting after intravenous administration of tramadol in the 1-min and 3-min groups were significantly related to the incidence of postoperative nausea and vomiting. The incidence of nausea and vomiting during pre-administration in the 1-min and 3-min groups was identified as an independent risk factor for postoperative nausea and vomiting. Conclusions: In the clinical treatment of pain with tramadol, the slow intravenous application of tramadol within 3 min is worthy of being adopted and promoted by clinicians in their daily work.

Role of daytime variation in pharmaceutical effects of sufentanil, dezocine, and tramadol: A matched observational study.

The role of daytime variation in the comprehensive pharmaceutical effects of commonly used opioid analgesics in clinical setting remains unclear. This study aimed to explore the differences in daytime variation among elective surgery patients who were scheduled to receive preemptive analgesia with equivalent doses of sufentanil, dezocine, and tramadol in the morning and afternoon. The analgesic effect was assessed by changes in the pressure pain threshold before and after intravenous administration of sufentanil, dezocine, and tramadol. Respiratory effects were evaluated using pulse oximetry, electrical impedance tomography, and arterial blood gas analysis. Other side effects, including nausea, sedation, and dizziness, were also recorded, and blood concentration was measured. The results showed that the analgesic effects of sufentanil, dezocine, and tramadol were significantly better in the morning than in afternoon. In the afternoon, sufentanil had a stronger sedative effect, whereas dezocine had a stronger inhibitory respiratory effect. The incidence of nausea was higher in the morning with tramadol. Additionally, significant differences in different side effects were observed among three opioids. Our results suggest that the clinical use of these three opioids necessitates the formulation of individualized treatment plans, accounting for different administration times, to achieve maximum analgesic effect with minimal side effects.

Effects of Intravenous Analgesia Using Tramadol on Postoperative Depression State and Sleep Quality in Women Undergoing Abdominal Endoscopic Surgery: A Randomized Controlled Trial.

Purpose: This study aimed to explore the effects of intravenous analgesia using tramadol on postoperative depression, anxiety, and sleep in women undergoing abdominal endoscopic surgery. Patients and Methods: Two hundred female patients (100 in each group) who underwent abdominal endoscopic surgery were recruited to randomly receive intravenous analgesia with sufentanil combined with tramadol (tramadol group) or sufentanil (control group). The primary outcome was the incidence of postoperative depression, which was assessed at 1, 2, and 3 days after surgery using the 13-item Beck Depression Inventory. The secondary outcomes were the incidence of anxiety and sleep quality, which were assessed using the 20-item Self-Rating Anxiety Scale and Richards-Campbell Sleep Questionnaire. Results: The incidence of depression (Beck depression scale≥4) during the 3-day follow-up in the control group was 51%, which was significantly higher than that in the tramadol group of 28% (relative risk [RR]=0.55; 95% confidence interval [CI], 0.38-0.79; P=0.001). No difference was found in the incidence of anxiety state (Self-Rating Anxiety Scale≥40) between the tramadol and control groups (7%vs 5%; RR=1.40; 95% CI, 0.46-4.25; P=0.552). All of the Richards-Campbell sleep scales of patients in the tramadol group at 1 (77.4±15.2 vs 64.2±20.1, P<0.001), 2 (84.1±14.9 vs 71.8±18.8, P<0.001), and 3 days (87.0±12.2 vs 70.3±21.0, P<0.001) after surgery were higher than those in the control group. Conclusion: Intravenous analgesia using tramadol can effectively improve the postoperative depression and sleep status of women undergoing abdominal endoscopic surgery. Tramadol is recommended for use in postoperative analgesia when improving postoperative mood, and sleep is needed in clinical practice.

[A novel mutation Glu441stop (GAA to TAA) of androgen receptor gene resulting in complete androgen insensitivity syndrome].

OBJECTIVE: To identify the mutation of human androgen receptor gene (AR) in a patient with complete androgen insensitivity syndrome (CAIS). METHODS: DNA sequences of 8 exons and their exon/intron boundaries of the AR gene in the patient were amplified by PCR and directly sequenced. RESULTS: DNA sequencing revealed a nonsense mutation in exon 1, resulting in a change of codon 441 GAA (glutamic acid) to a stop codon (TAA). CONCLUSION: A novel mutation Glu441stop (GAA to TAA) of the androgen receptor gene leading to complete androgen insensitivity syndrome was identified in this study in a Chinese patient. It may help us further understanding the pathogenesis of CAIS.