Document Detail


Comparison between intraoperative fentanyl and tramadol to improve quality of emergence.
MedLine Citation:
PMID:  22089326     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cough causes poor quality of emergence from anesthesia and risks of several complications. We compared fentanyl and an antitussive action of tramadol on the quality of emergence and postoperative outcome.
METHODS: A total of 110 adults (18 to 83 y) of American Society of Anesthesiologists physical status I-III undergoing elective lumbar microdiscectomy with intubated total intravenous anesthesia were randomly divided into 2 groups of 55 each. The patients assigned to the fentanyl group received a dose of 1 μg/kg of fentanyl, whereas those assigned to the tramadol group received 1 mg/kg of tramadol, at the beginning of skin closure. We recorded the incidence of cough, quality of extubation at fixed times, maximal heart rates, maximal blood pressure during emergence, postoperative pain scores, and consumption of fentanyl. In addition, postoperative sore throat (POST), hoarseness, postoperative nausea and vomiting, and other anesthetic and surgical-related complications were recorded.
RESULTS: Tramadol reduced cough incidence, improved extubation quality, and provided more stable hemodynamics during emergence. There was no significant difference in postoperative pain, fentanyl consumption, incidence and severity of POST, hoarseness, and postoperative nausea and vomiting between groups. Moreover, we found that the incidence of POST did not correlate with cough incidence.
CONCLUSIONS: A dose of 1 mg/kg of tramadol administered intravenously 30 minutes before the expected extubation, compared with 1 μg/kg of fentanyl, decreased cough incidence, improved emergence quality, and provided stable hemodynamics. However, there was no significant difference between tramadol and fentanyl in pain scores and fentanyl consumption postoperatively.
Authors:
Bo-Feng Lin; Da-Tong Ju; Chen-Hwan Cherng; Nan-Kai Hung; Chun-Chang Yeh; Shun-Ming Chan; Ching-Tang Wu
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of neurosurgical anesthesiology     Volume:  24     ISSN:  1537-1921     ISO Abbreviation:  J Neurosurg Anesthesiol     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-03-05     Completed Date:  2012-07-26     Revised Date:  2012-09-17    
Medline Journal Info:
Nlm Unique ID:  8910749     Medline TA:  J Neurosurg Anesthesiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  127-32     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Analgesics, Opioid / pharmacology*,  therapeutic use
Anesthesia Recovery Period*
Blood Pressure / drug effects
Cough / prevention & control
Diskectomy
Female
Fentanyl / pharmacology*,  therapeutic use
Heart Rate / drug effects
Humans
Intraoperative Period
Male
Middle Aged
Narcotics / pharmacology*,  therapeutic use
Pain, Postoperative / prevention & control
Postoperative Complications / prevention & control*
Severity of Illness Index
Tramadol / pharmacology*,  therapeutic use
Young Adult
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 0/Narcotics; 27203-92-5/Tramadol; 437-38-7/Fentanyl

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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