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1.
Medicine (Baltimore) ; 100(14): e22541, 2021 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-33832058

RESUMO

INTRODUCTION: The comparison of ketamine with tramadol for pain control remains controversial in pediatric adenotonsillectomy or tonsillectomy. We conduct a systematic review and meta-analysis to explore the efficacy of ketamine vs tramadol for pain relief in children following adenotonsillectomy or tonsillectomy. METHODS: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through October 2019 for randomized controlled trials (RCTs) assessing the effect of ketamine vs tramadol for pediatric adenotonsillectomy or tonsillectomy. This meta-analysis is performed using the random-effects model. RESULTS: Six RCTs are included in the meta-analysis. Overall, compared to ketamine group for pediatric adenotonsillectomy or tonsillectomy, tramadol is associated with substantially lower CHEOPS at 1 h (SMD = 1.56; 95% CI = 0.20-2.92; P = .02; low quality) and longer first time of additional pain medication (SMD = -0.47; 95% CI = -0.74 to -0.19; P = .0008; low quality), but demonstrates no obvious effect on CHEOPS at 6 h (SMD = 0.51; 95% CI = -1.17 to 2.19; P = .55; low quality), sedation scale at 1 h (SMD = -0.80; 95% CI = -3.07 to 1.48; P = .49; low quality) or additional pain medication (RR = 1.31; 95% CI = 0.85-2.02; P = .23; moderate quality). CONCLUSIONS: Tramadol may be better to alleviate the postoperative pain after pediatric adenotonsillectomy or tonsillectomy.


Assuntos
Analgésicos/uso terapêutico , Ketamina/uso terapêutico , Dor Pós-Operatória/terapia , Tramadol/uso terapêutico , Adenoidectomia/efeitos adversos , Analgésicos/farmacologia , Criança , Pré-Escolar , Feminino , Humanos , Ketamina/farmacologia , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Tonsilectomia/efeitos adversos , Tramadol/farmacologia
2.
Neurosciences (Riyadh) ; 26(2): 192-198, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33814373

RESUMO

OBJECTIVES: To compare the clinical outcomes of repetitive paravertebral block (PVB) combining oral medication in the treatment of zoster-related pain (ZP) with different courses. METHODS: Sixty-seven patients with ZP were divided into 3 groups based on their course of herpes zoster (HZ). Group I: 24 patients with acute herpetic neuralgia (within one month of disease onset); group II: 22 patients with subacute herpetic neuralgia (disease onset from 1 to 3 months); group III: 21 patients with postherpetic neuralgia (more than 3 months since disease onset). All patients received ultrasound-guided repetitive PVB with oral gabapentin and tramadol sustained-release tablets. The VAS and QS scores and the incidences of hematoma, dizziness, nausea, and drowsiness were compared at 1 day, 3 months, and 6 months after treatment. RESULTS: Pain intensity and sleep quality of the 3 groups improved to varying degrees after treatment. The best efficacy was achieved in the acute group, followed by the subacute group, and the poorest efficacy was observed in the chronic group. CONCLUSION: The efficacy of ultrasound-guided repetitive PVB with oral medication varied with the courses of HZ. The shorter the time since onset, the better the efficacy. This combined treatment showed better efficacy in patients at the acute and subacute stages and significantly improved their pain and sleep quality, while demonstrating limited pain relief in chronic patients.


Assuntos
Analgésicos/uso terapêutico , Gabapentina/uso terapêutico , Bloqueio Nervoso/métodos , Neuralgia Pós-Herpética/terapia , Tramadol/uso terapêutico , Idoso , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuralgia Pós-Herpética/tratamento farmacológico , Manejo da Dor/métodos , Medição da Dor , Ultrassonografia de Intervenção
3.
Rev. cuba. anestesiol. reanim ; 20(1): e681, ene.-abr. 2021. tab, graf
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1156364

RESUMO

Introducción: El estudio y tratamiento del dolor ha sido una de las preocupaciones más importantes en los últimos 30 años en el ámbito médico mundial. Desde hace varias décadas a nivel internacional se realizan estudios sobre el efecto del tramadol y la lidocaína como analgésicos intraoperatorio, con el fin de obtener una adecuada analgesia durante el procedimiento quirúrgico y el periodo posoperatorio inmediato. Objetivo: Comparar el efecto analgésico del tramadol y la lidocaína durante el período transoperatorio en caninos programados para intervención quirúrgica. Método: Se realizó un estudio prospectivo, comparativo, con animales programados para tratamiento quirúrgico por presentar tumores periféricos. Se incluyeron 10 animales divididos en 2 grupos. El grupo control (G-C) que recibió lidocaína sin preservo (lidocaína SP) en infusión continua durante el procedimiento quirúrgico y el grupo 1 (G-1) que se le administró tramadol endovenoso previo al acto quirúrgico. Se evaluaron variables hemodinámicas y de oxigenación como indicadores indirectos de dolor transoperatorio. Resultados: La muestra fue homogénea para la edad y el sexo. El comportamiento de las variables hemodinámicas resultó más estable durante la infusión de lidocaína. La saturación periférica de oxígeno fue similar con ambos medicamentos, así como la temperatura. Conclusiones: La infusión intravenosa de lidocaína SP durante el periodo transoperatorio en caninos oncológico demostró una mejor efectividad analgésica en comparación con el tramadol aplicado preoperatoriamente, según los parámetros evaluados(AU)


Introduction: Study and treatment of pain has been one of the most important concerns in the last thirty years in the worldwide medical field. For several decades, international studies have been carried out on the effect of tramadol and lidocaine as intraoperative analgesics, in order to achieve adequate analgesia during surgical procedures and the immediate postoperative period. Objective: To compare the analgesic effect of tramadol and lidocaine during the intraoperative period in canines scheduled for surgical intervention. Method: A prospective, comparative study was carried out with animals scheduled for surgical treatment due to peripheral tumors. Ten animals were included, divided into two groups: the control group, which received lidocaine without preservation in continuous infusion during the surgical procedure, and group 1, which was administered intravenous tramadol prior to the surgical act. Hemodynamic and oxygenation variables were assessed as indirect indicators of intraoperative pain. Results: The sample was homogeneous for age and sex. The behavior of the hemodynamic variables was more stable during the lidocaine infusion. Peripheral oxygen saturation was similar in both drugs, as well as temperature. Conclusions: Intravenous infusion of lidocaine without preservation during the intraoperative period in oncological canines showed better analgesic effectiveness compared to tramadol applied preoperatively, according to the parameters assessed(AU)


Assuntos
Animais , Tramadol/uso terapêutico , Anestesia e Analgesia/métodos , Lidocaína/uso terapêutico , Estudos Prospectivos
4.
Ecotoxicol Environ Saf ; 212: 111999, 2021 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-33550078

RESUMO

Tramadol is a widely used analgesic with additional antidepressant and anxiolytic effects. This compound has been reported in continental waters reaching concentrations of µg/L as a consequence of its inefficient removal in sewage treatment plants and increasing use over time. In this study, European chubs (Squalius cephalus) were exposed to 1 µg/L of tramadol in water for 42 days with a subsequent 14 days of depuration. Our results revealed that chubs exposed to this analgesic underwent changes in their behaviour as compared to the control group. The behavioural outcome was also influenced by the individual concentration of tramadol in brain tissue. In particular, experimental fish presented anxiolytic-like effects, characterized by less bold and less social individuals. Exposed animals were less frequently out of the shelter and moved a shorter distance, indicating that they explored the new environment less during the boldness test. In the novel object recognition experiment, although they distinguished the new item, they examined it less and displayed a reduced activity. Shoal cohesion was disrupted as observed in an increased distance between individuals. After the depuration phase, this alteration remained whereas the boldness effect disappeared. Moreover, the degree of behavioural changes was correlated with the concentration of the substance in brain. According to our findings, chronic presence of tramadol in the environment can impact the fitness of exposed aquatic fauna by altering evolutionary crucial behaviours.


Assuntos
Comportamento Animal/efeitos dos fármacos , Cyprinidae/fisiologia , Tramadol/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Encéfalo/efeitos dos fármacos , Encéfalo/metabolismo , Relação Dose-Resposta a Droga , Água Doce/química , Tramadol/metabolismo , Poluentes Químicos da Água/metabolismo
5.
BMJ Case Rep ; 14(1)2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33500301

RESUMO

A 75-year-old man was hospitalised for bronchoscopy with biopsy due to a suspicious pulmonary mass at chest tomography. He had significant dyspnoea, constipation, nausea, vomiting, anorexia and a 33% loss of weight in the past 3 months. Biopsy revealed a pulmonary squamous cell carcinoma, which was inoperable. Tramadol used at home for 3 months was replaced by morphine on admission. The patient remained constipated despite prokinetics and laxatives, leading to the diagnostic hypothesis of paraneoplastic motility disorder and opioid-induced constipation. Abdominal tomography ruled out the possibility of mechanical obstruction. As complications, the patient presented superior vena cava syndrome and opioid (morphine) intoxication. The patient died a few days later. The management of this case highlights the importance of multidisciplinary care and the challenges of palliative oncology care. Paraneoplastic motility disorder must always be considered among the mechanisms of intestinal dysfunction in patients with advanced oncological disease.


Assuntos
Carcinoma de Células Escamosas/complicações , Constipação Intestinal/etiologia , Gastroparesia/etiologia , Neoplasias Pulmonares/complicações , Síndromes Paraneoplásicas do Sistema Nervoso/etiologia , Idoso , Antieméticos/uso terapêutico , Carcinoma de Células Escamosas/diagnóstico por imagem , Constipação Intestinal/diagnóstico , Constipação Intestinal/tratamento farmacológico , Constipação Intestinal/fisiopatologia , Fármacos Gastrointestinais/uso terapêutico , Gastroenteropatias/diagnóstico , Gastroenteropatias/tratamento farmacológico , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Motilidade Gastrointestinal , Gastroparesia/diagnóstico , Gastroparesia/tratamento farmacológico , Gastroparesia/fisiopatologia , Glicerol/uso terapêutico , Humanos , Lactulose/uso terapêutico , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Metoclopramida/análogos & derivados , Metoclopramida/uso terapêutico , Morfina/efeitos adversos , Constipação Induzida por Opioides/diagnóstico , Cuidados Paliativos , Síndromes Paraneoplásicas do Sistema Nervoso/diagnóstico , Síndromes Paraneoplásicas do Sistema Nervoso/fisiopatologia , Tramadol/efeitos adversos
6.
Med Hypotheses ; 146: 110468, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33385878

RESUMO

Currently, no single medication has been approved for the management of coronavirus disease-2019 (COVID-19) caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therefore, drug repositioningby investigating the use of existing drugs for management of COVID-19 patients is considered a desperate need. Tramadol is a commonly prescribed analgesic drug for treatment of moderate to severe pain with less potential for dependence and respiratory depression. Multiple evidence support that tramadol is a promising drug for treatment of COVID-19 patients. Herein, we discuss the possible beneficial effects of using tramadol against SARS-CoV-2 infection and their underlying mechanism of action. The anti-inflammatory effect of tramadol may help to suppress the COVID-19 related cytokine storm through decreasing interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), and C-reactive protein (CRP). Besides, tramadol activates natural killer (NK) and T-cells and enhances IL-2 secretion, which produce immune-enhancing effect against SARS-CoV-2. Recent studies confirmed that COVID-19 patients with acute respiratory failure showed increased fibrin formation and polymerization that may lead to thrombosis. Tramadol owing to its hypocoagulable effect may protect against venous thromboembolism in these patients. Moreover, tramadol can exert a cardioprotective effect via decreasing lactate dehydrogenase (LDH) level which is elevated in most of patients with COVID-19. Furthermore, the severity and mortality of COVID-19 have been correlated with old age patients, which may be due to the lack of antioxidant mechanisms and increased oxidative damage. Tramadol could protect COVID-19 patient from disease complications by increases the antioxidant enzymes superoxide dismutase and glutathione peroxidase while diminished malondialdehyde. More interestingly, tramadol as an effective analgesic and antitussive may have a beneficial effect on COVID-19 patients suffering from cough, headache, ache, and pain. The tramadol anti-psychotic effect may also protect against psychiatric disorders associated with SARS-CoV-2 infection. Moreover, tramadol has bactericidal activity against a wide range of pathogens including Pseudomonas aeruginosa which is common in severe COVID-19 patients leading to pneumonia with worse clinical outcomes. Therefore, we hypothesize that tramadol might be a promising adjuvant therapeutic option against SARS-CoV-2 infection. Based on that, tramadol should be considered as adjuvant therapy for COVID-19 clinical trials.


Assuntos
/tratamento farmacológico , Tramadol/farmacologia , Analgésicos Opioides/farmacologia , Antibacterianos/farmacologia , Anti-Inflamatórios/farmacologia , Antidepressivos/farmacologia , Antioxidantes/farmacologia , /fisiopatologia , Reposicionamento de Medicamentos , Humanos , Fatores Imunológicos/farmacologia , Modelos Biológicos , Pandemias
7.
Am J Emerg Med ; 41: 16-20, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33383266

RESUMO

BACKGROUND: Serratus anterior plane block (SAPB) was evaluated that in patients with the complaint of rib fracture pain in terms of total analgesic consumption and pain scores. METHOD: Sixty patients with rib fracture and NRS (Numeric Rating Scala) pain scores equal or greater than four were included in randomized controlled study. Patients were randomized to perform SAPB or control group. Primary outcome was total tramadol consumption in 24 h. Secondary outcomes were NRS scores (after Patient Controlled Analgesia (PCA) application 30 min, first, second, 4 th, 6 th, 12 th, 24 th hour), peripheral oxygen saturation (first and 24 th hour after PCA application), chronic pain. and complications. RESULTS: The total tramadol consumption significantly lower in group S (p = 0.02). NRS scores after 30 min, 1 h, 2 h, 4 h, 6 h, 12 h, and 24 h were significantly lower in group S than in group C (p < 0.001, p < 0.001, p < 0.001, p < 0.001, p = 0.002, p = 0.026). The total number of patients who reported of chronic pain at rest and during effort was significantly lower in group SAPB than in group C (p = 0.006). Nine patients in group C were reported of pain, four of whom had pain at rest and five had pain during effort. One patient in group S was reported of pain during effort. CONCLUSION: This study demonstrated that SAPB, as part of multimodal analgesia in pain management due to rib fractures, is safe and effective in reducing acute pain.


Assuntos
Bloqueio Nervoso/métodos , Manejo da Dor , Dor/etiologia , Fraturas das Costelas/complicações , Adulto , Idoso , Analgésicos Opioides/administração & dosagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Estudos Prospectivos , Fatores de Tempo , Tramadol/administração & dosagem , Resultado do Tratamento
8.
BMJ Case Rep ; 13(12)2020 Dec 17.
Artigo em Inglês | MEDLINE | ID: mdl-33334741

RESUMO

A 23-year-old woman diagnosed with type 1 diabetes mellitus in 2011 came to our outpatient office because of an inability to walk correctly. She was under a basal bolus insulin regimen. In the summer of 2016, she experienced a rapid improvement in her glycaemic control. A few weeks later, she started to complain of a severe burning pain in the soles of her feet (pain score 10/10). Neither macrovascular nor microvascular complications were detected. The patient was forced to walk barefoot due to an intense pain using shoes or socks and used to soak her feet in water for several hours daily. She also developed severe intolerance to environmental heat, both indoors and outdoors. A diagnosis of treatment-induced diabetic neuropathy was made. The patient was admitted to a general ward to start pain therapy. After a 6-month course of different neuropathic pain drugs, the patient was able to walk autonomously again.


Assuntos
Diabetes Mellitus Tipo 1/tratamento farmacológico , Neuropatias Diabéticas/diagnóstico , Insulina/efeitos adversos , Neuralgia/diagnóstico , Diabetes Mellitus Tipo 1/complicações , Neuropatias Diabéticas/induzido quimicamente , Neuropatias Diabéticas/tratamento farmacológico , Dibenzazepinas/administração & dosagem , Quimioterapia Combinada/métodos , Eletromiografia , Feminino , , Gabapentina/administração & dosagem , Humanos , Neuralgia/induzido quimicamente , Neuralgia/tratamento farmacológico , Tramadol/administração & dosagem , Resultado do Tratamento , Teste de Caminhada , Adulto Jovem
9.
Am J Vet Res ; 81(12): 973-984, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33251843

RESUMO

OBJECTIVE: To determine the effects of gabapentin, tramadol, and meloxicam on tear production, intraocular pressure (IOP), pupillary diameter, tear break-up time, and corneal touch threshold in healthy dogs when given orally for 3 days. ANIMALS: 9 healthy research Beagles. PROCEDURES: A randomized, blinded, case-crossover study with a 6-sequence, 3-treatment, and 3-period design was performed. A 7-day acclimation period was followed by 3 treatment phases, each with a 3-day treatment period followed by a 7-day washout period for 3 different drugs. Block randomization was used to group dogs for treatments with drug A (gabapentin), B (tramadol), or C (meloxicam). Measurements of tear production, IOP, pupillary diameter, tear break-up time, and corneal touch threshold were performed on a schedule. A generalized mixed-effects linear regression model was created for each ocular variable, accounting for repeated measures within individuals. RESULTS: Intraocular pressure was the only variable to have differed substantially between the first 5 and last 2 days of the acclimation period. When treatment phase, day, time of day, dog identification, baseline value, and eye were accounted for, the mean IOP was lower for dogs during treatment phases with gabapentin or tramadol, compared with meloxicam, but this difference was not considered clinically meaningful. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that a minimum 5-day acclimation period is necessary for IOP measurements to return to baseline in dogs. The statistically identified effect of gabapentin and tramadol on IOP in dogs of the present study warrants further investigation. It is possible that at higher dosages, or in dogs with glaucoma, this effect may become clinically significant.


Assuntos
Tramadol , Animais , Estudos Cross-Over , Cães , Gabapentina , Pressão Intraocular , Meloxicam , Tonometria Ocular
10.
Polim Med ; 50(1): 33-40, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33125195

RESUMO

BACKGROUND: Co-processing starch with clay nanocomposite has been shown to yield a new class of materials, potentially with better properties than pristine starch, that could be used as directly compressible excipients in tablet formulations. OBJECTIVES: In this study, starches from 3 botanical sources, i.e., millet starch from Pennistum glaucum (L) RBr grains, sorghum starch from Sorghum bicolor L. Moench grains and cocoyam starch from Colocasia esculenta L. Schott tubers, were co-processed with montmorillonite clay (MMT) and evaluated as a directly compressible excipient in tramadol tablet formulations. The effects of different starch-to-clay ratios on the material and drug release properties of the resulting tablets were evaluated. MATERIAL AND METHODS: The starch-clay composites were prepared by heating a dispersion of the starch in distilled water, then precipitating the dispersion with an equal volume of 95% ethanol. The starch-clay composites were characterized and used as direct compression excipients for the preparation of tramadol tablets. The mechanical and drug release properties of the tablets were evaluated. RESULTS: Co-processing MMT with the starches yielded starch-clay composites with different material and tablet properties than the pristine starches. The co-processed starch-MMT biocomposites exhibited improved flowability and compressibility over the pristine starches. The mechanical and drug release properties of tramadol tablets containing starch-clay composites were significantly better than those containing only pristine starches. The properties of the starch-clay composites were not related to the botanical source of the starches. CONCLUSIONS: The study showed that starch-clay biocomposites could be used in the controlled release of tramadol.


Assuntos
Argila , Excipientes , Amido , Comprimidos , Tramadol , Composição de Medicamentos , Solubilidade
12.
Life Sci ; 260: 118430, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32931800

RESUMO

AIMS: Previous investigations demonstrated that tramadol, as a painkiller, similar to morphine induces tolerance and dependence. Furthermore, the cannabinoid receptor 1 (CB1R) located in the nucleus accumbens (NAc) plays a critical role in morphine-induced conditioning. Therefore, the main objective of this study was to evaluate the role of NAc CB1R in tramadol induced conditioning and reinstatement. MAIN METHODS: In the present experiment, the effect of NAc CB1 receptors on tramadol induced conditioning was tested by microinjecting of arachidonylcyclopropylamide (ACPA, CB1R agonist) and AM 251 (CB1R inverse agonist) in the NAc during tramadol-induced conditioning in the adult male Wistar rats. In addition, the role of NAc CB1R in the reinstatement was also evaluated by injecting ACPA and AM 251 after a 10-days extinction period. KEY FINDINGS: The obtained data revealed that the administration of tramadol (1,2, and 4 mg/kg, ip) dose-dependently produced conditioned place preference (CPP). Moreover, intra-NAc administration of ACPA (0.25, 0.5, and 1 µg/rat) dose-dependently induced conditioning, while the administration of AM-251 (30, 60, and 120 ng/rat) induced a significant aversion. In addition, the administration of a non-effective dose of AM251 during tramadol conditioning inhibited conditioning induced by tramadol. On the other hand, the administration of ACPA after extinction induced a significant reinstatement. Notably, the locomotor activity did not change among groups. SIGNIFICANCE: Previous studies have shown that tramadol-induced CPP occurs through µ-opioid receptors. The data obtained in the current study indicated that CB1R located in the NAc is involved in mediating conditioning induced by tramadol. Besides, CB1R also plays a vital role in the reinstatement of tramadol-conditioned animals. It might be due to the effect of opioids on enhancing the level of CB1R.


Assuntos
Analgésicos Opioides/efeitos adversos , Condicionamento Psicológico/efeitos dos fármacos , Núcleo Accumbens/efeitos dos fármacos , Receptor CB1 de Canabinoide/fisiologia , Tramadol/efeitos adversos , Analgésicos Opioides/administração & dosagem , Animais , Condicionamento Clássico , Relação Dose-Resposta a Droga , Extinção Psicológica/efeitos dos fármacos , Masculino , Núcleo Accumbens/metabolismo , Piperidinas/administração & dosagem , Piperidinas/farmacologia , Pirazóis/administração & dosagem , Pirazóis/farmacologia , Ratos Wistar , Receptor CB1 de Canabinoide/agonistas , Tramadol/administração & dosagem
13.
J Opioid Manag ; 16(4): 297-306, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32885838

RESUMO

Tramadol is a centrally acting dual-mechanism (opioid and monoamine reuptake inhibition) analgesic that has been noted to have a lower risk of abuse compared to conventional opioids such as morphine. Oral tramadol has been ap-proved in the United States since 1995 and intravenous (IV) tramadol has been widely prescribed outside the United States (OUS); nevertheless, IV tramadol has not yet been approved for use in the United States. This paper provides a review of the pharmacokinetics (PK) of the IV tramadol dosing regimen being developed in the United States, its abuse potential as documented in the literature, and its safety record in clinical practice, and discusses how IV tramadol may become a useful option for patients in the United States with acute pain.


Assuntos
Dor Aguda , Analgésicos Opioides , Transtornos Relacionados ao Uso de Opioides , Tramadol , Dor Aguda/tratamento farmacológico , Administração Intravenosa , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/farmacocinética , Humanos , Morfina , Tramadol/efeitos adversos , Tramadol/farmacocinética
14.
Eur. j. anat ; 24(5): 429-437, sept. 2020. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-195280

RESUMO

Tramadol is one of the most commonly abused drugs. It has been reported to impair testicular function in models. Citrus aurantifolia is a citrus fruit used extensively in beverages and herbal preparations. This study investigated the modulating role of aqueous zest extract of Citrus aurantifolia (AZECA) against tramadol-mediated testicular toxicity in rat. Twenty-five male rats were assigned to 5 groups and orally treated with distilled water (negative control) for 28 days, 30 mg/kg of tramadol (positive control) for 14 days, 30 mg/kg of tramadol for first two weeks and 50 (treatment 1) and 100 mg/kg (treatment 1) of AZECA for the last 2 weeks. Biochemical markers were evaluated and testes were stained routinely for morphometry. Results shows a significant (p<0.05) decrease in testosterone, FSH and LH, SOD, CAT and a significant increase MDA, IL-1 and TNF-alpha evidenced by a significant (p < 0.05) reduction in volumetric proportion of interstitium and seminiferous tubules-tunica propria, macrophages, blood vessels and lymphatic space, macrophages, connective tissue, diameter, cross-sectional area and number of pro-files of seminiferous tubules per unit area in group treated with tramadolalone. These parameters were significantly (p<0.05) negated in groups that had AZECA supplementation. This study has demonstrated that treatment with AZECA exerted a potent testiculo-protective activity against tramadol-induced testicular injury in rats


No disponible


Assuntos
Animais , Ratos , Urolitíase/induzido quimicamente , Citrus , Extratos Vegetais/uso terapêutico , Tramadol/uso terapêutico , Estresse Oxidativo/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Inflamação/tratamento farmacológico , Modelos Animais de Doenças , Testículo/anatomia & histologia , Testículo/efeitos dos fármacos , Infertilidade/veterinária , Ratos Sprague-Dawley
15.
Aust Vet J ; 98(10): 511-516, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32643182

RESUMO

OBJECTIVE: To characterise intramuscular ketamine-medetomidine-tramadol anaesthesia in hatchling green sea turtles (Chelonia mydas). STUDY DESIGN: Prospective clinical trial. ANIMALS: Ten hatchling green sea turtles. MATERIALS AND METHODS: Prior to anaesthesia, cardiopulmonary parameters, cloacal temperature, and venous blood gas and biochemistry were obtained from hatchling green sea turtles while they were being gently restrained. Animals were then anaesthetised with ketamine (5 mg kg-1 ), medetomidine (0.05 mg kg-1 ) and tramadol (5 mg kg-1 ) via intramuscular injection. Turtles were checked for the depth of anaesthesia at five-min intervals by recording reflexes (righting, palpebral, pinch, cloacal) and measuring heart rate, respiratory rate and cloacal temperature. After 20 min, a second venous blood sample was obtained for further blood gas and biochemical analysis and the medetomidine was antagonised using atipamezole (5:1 medetomidine, 0.25 mg kg-1 ). RESULTS: All turtles were successfully anaesthetised with a mean time to induction of 3.4 min (±1). In all animals, a loss of reflexes (except for palpebral reflex) and voluntary movement was observed for the entire 20 min. Anaesthesia resulted in marked apnoea for the duration of the procedure. Venous blood gas and biochemistry analysis indicated that a 20 min period of apnoea had no measurable effects on venous blood gas results. All turtles recovered uneventfully after atipamazole antagonisation, with a mean time to first breath 4.5 min (±3.7), and mean recovery time 15.5 min (±15.4). CONCLUSIONS AND CLINICAL RELEVANCE: Intramuscular ketamine-medetomidine-tramadol, antagonised with atipamazole appears to be an effective anaesthetic protocol in hatchling green sea turtles for short procedures with no deleterious effects on venous blood gases or biochemistry.


Assuntos
Anestesia/veterinária , Ketamina , Tramadol , Tartarugas , Anestésicos Combinados , Animais , Injeções Intramusculares/veterinária , Medetomidina , Estudos Prospectivos
16.
Int J Pharm Compd ; 24(4): 327-336, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32649306

RESUMO

Extemporaneous compounding in veterinary practice sometimes represents the only possibility for treating animals in the absence of appropriate commercial formulations, especially for particular species. This method involves manipulating pharmaceutical active ingredients to a suitable dosage and formulation for administration to humans or animals. However, veterinarians and pharmacists should focus on the risk of potential incompatibilities and instability of their preparations. To help practitioners in drug compounding, we investigated the stability of oral suspensions of tramadol, fluoxetine, and doxycycline in a commercial ready-to-use vehicle (SyrSpend). A validated high-performance liquid chromatography method was developed to assay these active pharmaceutical ingredients. The oral suspensions were prepared at two concentration ranges and were stored in amber glass bottles under refrigerated conditions and at room temperature. After 90 days, the average recovery rates were between 90% and 110% for tramadol (5 mg/mL to 30 mg/mL) and doxycycline  (2 mg/mL to 10 mg/mL) without organoleptic modification. For fluoxetine, only the formulation at 2 mg/mL was stable; at higher concentrations, the uniformity of the suspension was compromised.


Assuntos
Amido , Administração Oral , Cromatografia Líquida de Alta Pressão , Doxiciclina , Composição de Medicamentos , Estabilidade de Medicamentos , Armazenamento de Medicamentos , Fluoxetina , Humanos , Suspensões , Tramadol
17.
J Card Surg ; 35(7): 1525-1530, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32579779

RESUMO

BACKGROUND: The optimum cardiac surgical pain management has known to maintain hemodynamic stability and, reduces respiratory and cardiovascular complications. Postoperative parasternal intercostal block has shown to reduce postoperative analgesic consumption after cardiac surgery. Therefore, this study sought to investigate the effectiveness of the preoperative ultrasound guided parasternal block in reducing postoperative pain after cardiac surgery. METHODS: This was a randomized, prospective, interventional, single blind study comprised of 90 adult patients scheduled for cardiac surgery involving sternotomy. Preoperatively and postoperatively, 0.25% bupivacaine administered in 4 mL aliquots into the anterior (2nd-6th) intercostal spaces on each side about 2 cm lateral to the sternal edge with a total volume of 40 mL under ultrasound guidance and direct vision, respectively. Postoperative pain was rated according to visual analogue scale. Secondary outcomes included intraoperative and postoperative fentanyl consumptions, dosages of rescue medications, and time to extubation. MAIN RESULTS: There was no significant differences in visual analogue score visual analogue score at all time points till 24 hours postoperatively. Intraoperative fentanyl requirements (microgram/kg) before cardiopulmonary bypass was significantly lower in pre-incisional group than the post-incisional group (0.16 ± 0.43 vs 0.68 ± 0.72; P = .0001). Furthermore, there were no significant difference in total fentanyl requirement (7.20 ± 2.66 vs 8.37 ± 3.13; P = .06) and tramadol requirement (0.02 ± 0.15 vs 0.07 ± 0.26; P = .28) within first 24 hours. However, time to extubation was significantly higher in the preoperative group (P = .02). CONCLUSIONS: Preoperative and postoperative parasternal intercostal block provide comparable pain relief during the postoperative period.


Assuntos
Bupivacaína/administração & dosagem , Procedimentos Cirúrgicos Cardíacos , Bloqueio Nervoso/métodos , Manejo da Dor/métodos , Dor Pós-Operatória/prevenção & controle , Cuidados Pré-Operatórios/métodos , Esterno/inervação , Cirurgia Assistida por Computador/métodos , Ultrassonografia de Intervenção/métodos , Adulto , Feminino , Fentanila/administração & dosagem , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/diagnóstico , Estudos Prospectivos , Esternotomia , Tramadol/administração & dosagem , Resultado do Tratamento , Adulto Jovem
18.
Medicine (Baltimore) ; 99(24): e20405, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541462

RESUMO

BACKGROUND: The efficacy and safety of buprenorphine transdermal patch (BTP) has been well established in chronic pain, but data regarding acute postoperative pain relief is still very limited. Therefore, we design a prospective, randomized, controlled study to evaluate the effectiveness and safety of the BTP for postoperative analgesia in total hip arthroplasty. METHODS: This study is designed as a single-center, prospective, double-blind, randomized controlled trial. Group A receives a 10 mg patch of buprenorphine at the conclusion of surgery which is continued for 14 days. Group B receives a conventional analgesic regimen, that is, IV paracetamol 1 mg every 8 hours alternating with parenteral tramadol 50 mg every 8 hours for the first 2 postoperative days followed by oral administration of the same drug still the end of 2 weeks. A total of 160 patients are needed with an allowance for 10% drop-out. The primary outcome of this noninferiority study is opioid consumption within the first 24 hours following surgery. The secondary outcomes included numerical rating scale scores at rest, postoperative complications, length of hospital stay, and patient satisfaction. RESULTS: This trial is expected to be the largest randomized trial assessing the efficacy of BTP after primary total hip arthroplasty and powered to detect a potential difference in the primary outcome. TRIAL REGISTRATION NUMBER: This study protocol was registered in Research Registry (researchregistry5524).


Assuntos
Analgésicos Opioides/uso terapêutico , Artroplastia de Quadril/efeitos adversos , Buprenorfina/uso terapêutico , Dor Pós-Operatória/tratamento farmacológico , Adesivo Transdérmico/efeitos adversos , Acetaminofen/administração & dosagem , Acetaminofen/uso terapêutico , Administração Intravenosa , Administração Oral , Analgésicos não Entorpecentes/administração & dosagem , Analgésicos não Entorpecentes/uso terapêutico , Analgésicos Opioides/administração & dosagem , Buprenorfina/administração & dosagem , Estudos de Casos e Controles , Método Duplo-Cego , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Medição da Dor/estatística & dados numéricos , Medição da Dor/tendências , Satisfação do Paciente/estatística & dados numéricos , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Tramadol/administração & dosagem , Tramadol/uso terapêutico
19.
Saudi Med J ; 41(6): 640-644, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32518932

RESUMO

OBJECTIVES: To investigate whether preoperative oral gabapentin could reduce postoperative pain, analgesic consumption and the occurrence of catheter-related bladder discomfort (CRBD). Methods: In this study, participants randomly received either 600 mg gabapentin or placebo orally 2 h prior to transurethral prostate resection. Visual analogue scale and Ramsay sedation scale was utilized to assess pain intensity and sedation status after surgery. Intravenous 1.5 mg.kg-1 tramadol was used for postoperative analgesia. Pain intensity, sedation status, CRBD, tramadol consumption, side effects and the overall satisfaction degree were assessed and recorded for 48 h after tracheal extubation.  Results: Ninety participants given gabapentin and 91 participants given placebo completed the study. Lower visual analogue scale scores, less tramadol consumption, longer time to the first analgesic requirement, lower incidence of CRBD and nausea and higher satisfaction degree were detected in the patients receiving gabapentin compared with the patients receiving placebo.  Conclusion: Preoperative oral gabapentin reduced postoperative visual analogue scale scores, tramadol consumption and the occurrence rate of CRBD and nausea, and consequently, increased the degree of patients' satisfaction after transurethral prostate resection.


Assuntos
Anestesia Geral , Gabapentina/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/etiologia , Ressecção Transuretral da Próstata , Administração Oral , Idoso , Método Duplo-Cego , Uso de Medicamentos , Humanos , Masculino , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/prevenção & controle , Cuidados Pré-Operatórios , Tramadol , Resultado do Tratamento , Bexiga Urinária , Cateteres Urinários/efeitos adversos
20.
Mymensingh Med J ; 29(2): 303-310, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32506083

RESUMO

Gall stone disease is one of the most common conditions encountered in general surgical practices in adult population. The gold standard treatment for symptomatic gall stone disease is laparoscopic cholecystectomy. It results in less post-operative pain as compared to open cholecystectomy but post-operative pain may be mild, moderate or even severe in some patients. This Randomized control trail was conducted to In-patient department of Surgery, Mymensingh Medical College & Hospital (MMCH), Mymensingh, Bangladesh from April 2018 to September 2018. It was undertaken to evaluate the analgesic effect of intra-peritoneal tramadol instillation in patients undergoing laparoscopic cholecystectomy. Total 70 patients with symptomatic gallstone disease undergoing laparoscopic cholecystectomy were randomized equally in two groups. Then patients were selected in according to the inclusion and exclusion criteria. In first group (Group A), patients were received intra-peritoneal tramadol 100mg (diluted in 20.0ml distilled water). Sprayed 10.0ml diluted tramadol into the sub diaphragmatic area, 5.0ml into the area of gall bladder bed and 5.0ml into the space between the liver and kidney under direct vision just before removal of trocars. In second group (Group B) the conventional operative procedure was followed. Postoperatively, patient was extubated and shifted to recovery room. Data recorded and analyzed, such as post-operative pain score at 1, 4, 8, and 24 hour; cumulative 1, 8 and 24 hour analgesic consumption. In addition that postoperative hospital period monitoring of heart rate, blood pressure, respiratory rate, temperature at 0, 4, 8, 24 hours was also analyzed. Intensity of pain was assessed by Visual Analogue Scale (VAS) scoring system. Patients showed a VAS ≥3 or patients who requested for analgesia was administrated a supplemental dose of analgesic. In the present study the mean pain scores in Group A were found to be low at1hourpost-operative was 0.60±0.56 and there was a gradual increase in score in respect of time interval with peak of 2.07±0.91 at 24 hours. Whereas, in Group B the mean pain scores immediate post-operative period were at its peak was, 2.50±0.82 which decreased to 1.30±0.84 at 1 hour and further there was rise at 4 hours (2.10±0.71) and 24 hours (2.33±0.0.71). But at any point of time the mean VAS remained significantly low (p<0.050) in patients with Group A compared to Group B except at 1st 24 hours (p=0.210). Intra-peritoneal instillation of tramadol for postoperative pain control in laparoscopic cholecystectomy has beneficial effect in terms of postoperative pain relief following laparoscopic cholecystectomy.


Assuntos
Colecistectomia Laparoscópica , Tramadol , Adulto , Bangladesh , Método Duplo-Cego , Humanos , Dor Pós-Operatória
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