Archives of Anesthesiology and Critical Care 2016. 2(4):243-248.

Evaluation of prophylactic injection of two doses of tramadol on the heart rate and blood pressure changes after laryngoscopy and tracheal intubation
Azim Honarmand, Mohammad Reza Safavi, Farhad Mahmoudi, Behnaz Sohrabi, Mohammad Emami, Dorna Masaeli, Hussein Nourian


Background: Laryngoscopy is an invasive technique that is associated with severe cardiovascular complications. This study was designed to compare the preventing effect of two doses tramadol injection on the heart rate and blood pressure changes after laryngoscopy and tracheal intubation in elective surgical patients.

Methods: In this clinical trial study, 189 elective surgical patients randomly divided to three groups: Group A and Group B, received tramadol 1mg/kg, 2mg/kg iv 5 minutes before induction of anesthesia respectively; Group C, received normal saline. The heart rate(HR), systolic blood pressure(SBP), diastolic blood pressure(DBP) and mean arterial pressure(MAP) were measured just before induction of anesthesia, just before laryngoscopy, at 1, 3, 5, 10 minutes after laryngoscopy and tracheal intubation.

Results: Mean HR, SBP, DBP and MAP changes at 1, 3, 5, 10 minutes after laryngoscopy was significantly less in Group B, compared with Group A and Group C(P<0.05). The incidence of tachycardia (6.3% vs. 19% and 28.6% respectively) and hypertension (4.8% vs. 15.9% and 22.2% respectively) was significantly less in Group B compared with Group A and C (P < 0.05).

Conclusion: Administration of tramadol with dosage of 2mg/kg iv 5 minutes before induction of anesthesia, significantly attenuated blood pressure and heart rate changes till 10 minutes after laryngoscopy and endotracheal intubation compared with using tramadol 1mg/kg iv.


tramadol; laryngoscopy; cardiovascular complications

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