Research Article

Evaluation of Prophylactic Injection of Two Doses of Tramadol on the Heart Rate and Blood Pressure Changes after Laryngoscopy and Tracheal Intubation

Abstract

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.

Splinter WM, Cervenko F. Haemodynamic responses to laryngoscopy and tracheal intubation in geriatric patients: effects of fentanyl, lidocaine and thiopentone. CJA. 1989; 36(4):370-6.

Nishikawa K, Omote K, Kawana S, Namiki A. A comparison of hemodynamic changes after endotracheal intubation by using the lightwand device and the laryngoscope in normotensive and hypertensive patients. Anesth Analg. 2000; 90(5):1203-7.

Bruder N, Ortega D, Granthil C, editors. [Consequences and prevention methods of hemodynamic changes during laryngoscopy and intratracheal intubation]. Ann Fr Anesth Reanim. 1992; 11(1):57-71.

Kumar S, Mishra M, Mishra L, Bathla S. Comparative study of the efficacy of iv esmolol, diltiazem and magnesium sulphate in attenuating haemodynamic response to laryngoscopy and tracheal intubation. Indian J Anaesth. 2003;47(1):41-4.

Sonne N, Clausen T, Valentin N, Halck S, Munksgaard A. Total intravenous anaesthesia for direct laryngoscopy: propofol infusion compared to thiopentone combined with midazolam and methohexitone infusion. Acta Anaesthesiol Scand. 1992;36(3):250-4.

Sitzman BT, Rich GF, Rockwell JJ, Leisure G, Durieux M, DiFazio C. Local anesthetic administration for awake direct laryngoscopy. Are glossopharyngeal nerve blocks superior? Anesthesiology. 1997; 86(1):34-40.

Eggers K, Power I. Tramadol. Br J Anesth. 1995;74(3):247-9.

Reeves RR, Burke RS. Tramadol: basic pharmacology and emerging concepts. Drugs of today (Barc). 2008; 44(11):827-36.

Raffa RB, Friderichs E, Reimann W, Shank RP, Codd EE, Vaught JL. Opioid and nonopioid components independently contribute to the mechanism of action of tramadol, an'atypical'opioid analgesic. J Pharmacol Exp Ther. 1992; 260(1):275-85.

Lange-Asschenfeldt C, Weigmann H, Hiemke C, Mann K. Serotonin syndrome as a result of fluoxetine in a patient with tramadol abuse: plasma level-correlated symptomatology. J Clin Psychopharmacol. 2002; 22(4):440-1.

Wang JT, Chung CC, Whitehead RA, Schwarz SK, Ries CR, MacLeod BA. Effects of local tramadol administration on peripheral glutamate-induced nociceptive behaviour in mice. Can J Anaesth. 2010; 57(7):659-63.

Shiga Y, Minami K, Shiraishi M, Uezono Y, Murasaki O, Kaibara M, et al. The inhibitory effects of tramadol on muscarinic receptor-induced responses in Xenopus oocytes expressing cloned M3 receptors. Anesth Analg. 2002; 95(5):1269-73.

Russell JI, Kamin M, Bennett RM, Schnitzer TJ, Green JA, Katz WA. Efficacy of tramadol in treatment of pain in fibromyalgia. J Clin Rheumatol. 2000; 6(5):250-7.

Scott LJ, Perry CM. Tramadol. Drugs. 2000; 60(1):139-76.

Anwar ul H, Khan FA. Effect of addition of tramadol to one MAC sevoflurane on the haemodynamic response to laryngoscopy and tracheal intubation. J Coll Physicians Surg Pak. 2013; 23(3):173-7.

Koh LK, Kong CE, Ip-Yam PC. The modified Cormack-Lehane score for the grading of direct laryngoscopy: evaluation in the Asian population. Anaesth Intensive Care. 2002; 30(1):48-51.

Guignard B, Menigaux C, Dupont X, Fletcher D, Chauvin M. The effect of remifentanil on the bispectral index change and hemodynamic responses after orotracheal intubation. Anesth Analg. 2000; 90(1):161-7.

Dayer P, Desmeules J, Collart L. [Pharmacology of tramadol]. Drugs. 1997; 53 Suppl 2:18-24.

Enggaard TP, Poulsen L, Arendt-Nielsen L, Brosen K, Ossig J, Sindrup SH. The analgesic effect of tramadol after intravenous injection in healthy volunteers in relation to CYP2D6. Anesth Analg. 2006; 102(1):146-50.

Sevcik J, Nieber K, Driessen B, Illes P. Effects of the central analgesic tramadol and its main metabolite, O‐desmethyltramadol, on rat locus coeruleus neurones. Br J Pharmacol. 1993; 110(1):169-76.

Güven M, Mert T, Günay I. Effects of tramadol on nerve action potentials in rat: comparisons with benzocaine and lidocaine. Int J Neurosci. 2005; 115(3):339-49.

Files
IssueVol 2 No 4 (2016): Autumn QRcode
SectionResearch Article(s)
Keywords
tramadol laryngoscopy cardiovascular complications

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Honarmand A, Safavi MR, Mahmoudi F, Sohrabi B, Emami M, Masaeli D, Nourian H. Evaluation of Prophylactic Injection of Two Doses of Tramadol on the Heart Rate and Blood Pressure Changes after Laryngoscopy and Tracheal Intubation. Arch Anesth & Crit Care. 2016;2(4):243-248.