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BJA Advance Access published online on October 14, 2005
British Journal of Anaesthesia, doi:10.1093/bja/aei260
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org
Accepted September 22, 2005

Clinical Investigation

Analgesic and antacid properties of i.m. tramadol given before Caesarean section under general anaesthesia

M. Elhakim 1*, W. Abd El-Megid 1, A. Metry 1, A. El-hennawy 1, and K. El-Queseny 1

1 Department of Anaesthesia, Faculty of Medicine, Ain-Sham University, Cairo, Egypt

* To whom correspondence should be addressed.
M. Elhakim, E-mail: mokhtar.elhakim{at}gmail.com


  Abstract

Background. Intramuscular (i.m.) tramadol increases gastric pH during anaesthesia similar to famotidine. We investigated the antacid analgesic value of a single dose of i.m. tramadol given 1 h before elective Caesarean section performed under general anaesthesia.

Methods. Sixty ASA I parturients undergoing elective Caesarean section were included in a randomized double-blind study. The patients were randomly allocated to receive i.m. tramadol 100 mg (n=30) or famotidine 20 mg (n=30) 1 h before general anaesthesia.

Results. At the beginning and the end of anaesthesia, patients receiving tramadol had a median gastric fluid pH of 6.4, which was not significantly different from those treated with famotidine (median 6.3). The infant well-being, as judged by Apgar score, cord blood gas analysis, and neurobehavioural assessment showed no significant difference between the two groups. Nalbuphine consumption in the first 24 h after operation was reduced by 35% in the tramadol group. Pain intensity score on sitting and sedation were significantly greater in famotidine group up to 24 h after surgery. There was no significant difference in incidence and severity of nausea and vomiting between the two groups.

Conclusion. A single i.m. dose of tramadol is useful pre-treatment to minimize the risk of acid aspiration during operation, and in improving pain relief during 24 h after surgery.

Keywords: anaesthesia, obstetric; analgesics opioid, tramadol; antacid, famotidine.
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[Abstract] [Full Text] [PDF]

E-letters:

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Antacid properties of preoperative i.m. tramadol
kingsley Barasua Pepple
British Journal of Anaesthesia, 3 Jan 2006 [Full text]
Tramadol in Pregnancy
RACHNA SHANKAR
British Journal of Anaesthesia, 5 Jan 2006 [Full text]
Additional use of Tramadol in Parturients
Dr Snehal Ramnath Kumbhare
British Journal of Anaesthesia, 9 Jan 2006 [Full text]
Tramadol in caesarean section under general anesthesia
rajesh mahajan, et al.
British Journal of Anaesthesia, 13 Feb 2006 [Full text]
Reply
M Elhakim
British Journal of Anaesthesia, 15 Feb 2006 [Full text]
Re: Additional use of Tramadol in Parturients
Mokhtar Elhakim, et al.
British Journal of Anaesthesia, 21 Feb 2006 [Full text]
Re: Tramadol in Pregnancy
mokhtar Elhakim, et al.
British Journal of Anaesthesia, 21 Feb 2006 [Full text]
Re: Antacid properties of preoperative i.m. tramadol
mokhtar Elhakim, et al.
British Journal of Anaesthesia, 21 Feb 2006 [Full text]

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