Research Article

Effects of Oral Tizanidine Premedication on Pain and Hemodynamic Responses after Spinal Needle Skin Puncture

Abstract

Background: Although a variety of methods have been suggested to reduce stress, anxiety and pain intensity due to spinal needle skin puncture, their adverse effects restrict theirs widespread administration. In this study we evaluated the effects of oral Tizanidine on the reduction of pain caused by spinal needle puncture and hemodynamic responses.
Methods: In this double blind randomized clinical trial, 52 patients who were scheduled for elective surgeries under spinal anesthesia were recruited. They were randomly allocated in 2 groups of case and control. In the case group 4mg oral Tizanidine was administered to patients one hour before surgery while control group received placebo  Heart rate, systolic and diastolic blood pressure were recorded  exactly before spinal needle puncture and 1,3 and 5 minutes after spinal anesthesia.
Results: The mean average of pain score was significantly lower in case group (p< 0.001). Also hemodynamic variables, in terms of heart rate and diastolic blood pressure, were statistically different between two groups (p=0.04 and p=0.02); however, the difference between systolic blood pressure was not significant between two groups.
Conclusion: Premedication with 4mg oral Tizanidine produced stability in blood pressure and heart rate during surgery and reduced pain intensity caused by needle puncture.

Miller, D Ronald. Textbook of Miller’s Anesthesia. Sixth Edition, Spinal anesthesia, Ch 56:1619-1627

Imani F, Faiz HR, Sedaghat M, Hajiashrafi M. Effects of Adding Ketamine to Fentanyl plus Acetaminophen on Postoperative Pain by Patient Controlled Analgesia in Abdominal Surgery. Anesth Pain Med. 2014; 4(1): e12162.

Zhou HY, Chen SR, Pan HL. Targeting N-methyl-D-aspartate receptors for treatment of neuropathic pain. Expert Rev Clin Pharmacol. 2011; 4(3): 379–388.

Hashemian AM, Omraninava A, Kakhki AD, Sharifi MD, Ahmadi A, Masoumi B, et al. Effectiveness of local anesthesia with

Lidocaine in chronic opium abusers. J Emerg Trauma Shock. 2014; 7(4):301-4.

Tabari M., Alipour M., Esalati H. Evaluation of Oral Tizanidine Effects on [intraoperative] Hemodynamic Responses during Direct Laryngoscopy under General Anesthesia. Iran Red Crescent Med J. 2013; 15(7): 541-6.

Miettinen TJ, Kanto JH, Salonen MA, Scheinin M. The sedative and sympatholytic effects of oral Tizanidine in healthy volunteers. Anesth Analg. 1996; 82(4):817-820.

Yanagita T, Yamamura H, Igarashi S. Effects of Tizanidine in healthy volunteers: Double blind study compared with Diazepam and Placebo. Int J Clin Pharmacol Res. 1988; 8(2):75-94.

Coward DM. Tizanidine: Neuropharmacology and mechanism of action. Neurology. 1994; 44(suppl 9): S6-10.

Allen H. Hord, Donald D. Delson, M. Isabel Azevedo. Systemic Tizanidine Hydrochloride (Zanaflex TM) partially decreases experimental postoperative pain in rats. Anesth Analg. 2001; 93(5):1307-9.

Omote K., Satoh O., Sonoda H., Kumetay, Yamayak, Namiki A. [Effects of oral alpha 2 adrenergic agonists, clonidine and tizanidine, on tetracaine spinal anesthesia]. Masui. 1995; 44(6):816-23.

Imanaga K, Wajima Z, Inoue T, Ogawa R. Effect of oral Tizanidine on local-anesthetic infiltration pain during Epidural catheterization. J Nippon Med Sch. 2004; 71(2):105-10.

Wajima Z, Yoshikawa T, Ogura A, Imanaga K, Shiga T, Inoue T, et al. Oral Tizanidine, an alpha 2 adrenoceptor Agonist, reduces the minimum alveolar concentration of Sevoflurane in human adults. Anesth Analg. 2002; 95(2): 393-6.

Files
IssueVol 1 No 1 (2015): Winter QRcode
SectionResearch Article(s)
Keywords
Tizanidine premedication spinal anesthesia pain hemodynamic response

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Shoeibi G, Soltani Mohammadi S, Ahangari A, Marashi S, Borji A, Yaghooti AA. Effects of Oral Tizanidine Premedication on Pain and Hemodynamic Responses after Spinal Needle Skin Puncture. Arch Anesth & Crit Care. 2015;1(1):18-20.