Categories
Change Password!
Reset Password!
A 4-phenyl-piperidine analogue of codeine, Tramadol presents known for its central opioidergic, serotonergic analgesic, peripheral local anaesthetic, and noradrenergic attributes
During the surgery, brachial plexus block (BPB)
method was used as anesthesia and analgesia. Also, local anesthetics (LA) have
been used as an adjuvant to extend the pain relief. However, the effect of LA
on BPB are controversial. Therefore, this meta-analysis describes the use of
tramadol 100 mg as an adjuvant to LA to prolong the duration of sensory block,
motor block, and analgesia.
A 4-phenyl-piperidine analogue of codeine, Tramadol
presents known for its central opioidergic, serotonergic analgesic, peripheral local anaesthetic, and
noradrenergic attributes. Several studies have described contradictory verdicts
about the peripheral analgesic influence of Tramadol as an adjuvant to LA
during brachial plexus block (BPB). This meta-analysis intended to assess the
impacts of Tramadol as an adjunct to LA in BPB during the shoulder or upper
extremity surgery.
EMBASE, KoreaMed databases, PubMed, Google Scholar, and
Cochrane were searched to find the suitable randomised controlled trials (RCTs)
that involved comparison of BPB with LA and Tramadol and BPB with LA alone. The
impacts of Tramadol as an adjuvant on the duration of the motor block, sensory
block, and analgesia were considered as the primary endpoints. The implications
of Tramadol as an adjuvant on time to onset of motor block and sensory block
and adverse events were regarded as the secondary endpoints. Review Manager 5.3
software was used to conduct the meta-analysis.
A total of 16 RCTs comprising 751 patients were selected.
As compared to the BPB without Tramadol, BPB with Tramadol prolonged the
duration of the motor block, sensory block, and analgesia. The time to onset of
motor block and sensory block also reduced using the Tramadol. The duration of
the motor block, sensory block and analgesia were increased for BPB with
Tramadol 100 mg but not with Tramadol 50 mg. As per the GRADE system, the
duration of analgesia exhibited a high quality of evidence. The studies showed
similar adverse effects.
In upper extremity surgery conducted below BPB, an
introduction of 100 mg Tramadol as an adjuvant to LA seems to increase the duration
of the motor block, sensory block, and analgesia, and decrease the time to
onset of motor and sensory blocks without affecting adverse effects.
PLoS One. 2017 Sep 27;12(9):e0184649
Effect of tramadol as an adjuvant to local anesthetics for brachial plexus block: A systematic review and meta-analysis
Hye Won Shin et al.
Comments (0)