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Intraoperative tramadol reduces shivering but not pain after remifentanil-isoflurane general anaesthesia. A placebo-controlled, double-blind trial.
Eur J Anaesthesiol. 2008 Jun; 25(6):468-72.EJ

Abstract

BACKGROUND AND OBJECTIVE

Postoperative shivering and pain are frequent problems in patients recovering from anaesthesia with particularly high incidences being observed after remifentanil-isoflurane-based general anaesthesia. The opioid tramadol is generally effective in preventing shivering and treating pain, but its effects are not characterized after remifentanil-based general anaesthesia. This randomized, placebo-controlled, double-blind study evaluated the effects of intraoperative intravenous tramadol on postoperative shivering and pain after remifentanil-based general anaesthesia.

METHODS

After Ethics Committee approval, 60 patients scheduled for lumbar disc surgery were included. Surgery was performed under general anaesthesia (remifentanil, isoflurane). Patients were randomly assigned to receive 2 mg kg(-1) tramadol in 30 mL 0.9% saline infused intravenously (n = 30) or 30 mL saline (n = 30) 45-30 min before skin closure. The following parameters were assessed every 10 min for 2 h: shivering, pain, postoperative nausea and vomiting, sedation, heart rate, non-invasive blood pressure and peripheral oxygen saturation. The primary outcome variable was the incidence of shivering during the first 2 postoperative hours. Secondary variables were: shivering intensity, pain, postoperative nausea and vomiting, sedation, heart rate, non-invasive blood pressure and peripheral oxygen saturation.

RESULTS

Shivering was less frequent in patients treated with tramadol (20% vs. 70%, P = 0.0009) and was of lower intensity (severe shivering: 10% vs. 46.7%, P = 0.003). Pain scores were similar between the groups and all other secondary outcome variables failed to reveal significant differences.

CONCLUSIONS

Compared with placebo, intraoperative intravenous administration of 2 mg kg(-1) tramadol reduces the incidence and extent of postoperative shivering without alterations in pain perception after lumbar disc surgery under remifentanil-isoflurane-based general anaesthesia.

Authors+Show Affiliations

Johannes Gutenberg-University, Department of Anaesthesiology, Mainz, Germany. heid@uni-mainz.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18289446

Citation

Heid, F, et al. "Intraoperative Tramadol Reduces Shivering but Not Pain After Remifentanil-isoflurane General Anaesthesia. a Placebo-controlled, Double-blind Trial." European Journal of Anaesthesiology, vol. 25, no. 6, 2008, pp. 468-72.
Heid F, Grimm U, Roth W, et al. Intraoperative tramadol reduces shivering but not pain after remifentanil-isoflurane general anaesthesia. A placebo-controlled, double-blind trial. Eur J Anaesthesiol. 2008;25(6):468-72.
Heid, F., Grimm, U., Roth, W., Piepho, T., Kerz, T., & Jage, J. (2008). Intraoperative tramadol reduces shivering but not pain after remifentanil-isoflurane general anaesthesia. A placebo-controlled, double-blind trial. European Journal of Anaesthesiology, 25(6), 468-72. https://doi.org/10.1017/S0265021508003645
Heid F, et al. Intraoperative Tramadol Reduces Shivering but Not Pain After Remifentanil-isoflurane General Anaesthesia. a Placebo-controlled, Double-blind Trial. Eur J Anaesthesiol. 2008;25(6):468-72. PubMed PMID: 18289446.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intraoperative tramadol reduces shivering but not pain after remifentanil-isoflurane general anaesthesia. A placebo-controlled, double-blind trial. AU - Heid,F, AU - Grimm,U, AU - Roth,W, AU - Piepho,T, AU - Kerz,T, AU - Jage,J, Y1 - 2008/02/21/ PY - 2008/2/22/pubmed PY - 2008/10/8/medline PY - 2008/2/22/entrez SP - 468 EP - 72 JF - European journal of anaesthesiology JO - Eur J Anaesthesiol VL - 25 IS - 6 N2 - BACKGROUND AND OBJECTIVE: Postoperative shivering and pain are frequent problems in patients recovering from anaesthesia with particularly high incidences being observed after remifentanil-isoflurane-based general anaesthesia. The opioid tramadol is generally effective in preventing shivering and treating pain, but its effects are not characterized after remifentanil-based general anaesthesia. This randomized, placebo-controlled, double-blind study evaluated the effects of intraoperative intravenous tramadol on postoperative shivering and pain after remifentanil-based general anaesthesia. METHODS: After Ethics Committee approval, 60 patients scheduled for lumbar disc surgery were included. Surgery was performed under general anaesthesia (remifentanil, isoflurane). Patients were randomly assigned to receive 2 mg kg(-1) tramadol in 30 mL 0.9% saline infused intravenously (n = 30) or 30 mL saline (n = 30) 45-30 min before skin closure. The following parameters were assessed every 10 min for 2 h: shivering, pain, postoperative nausea and vomiting, sedation, heart rate, non-invasive blood pressure and peripheral oxygen saturation. The primary outcome variable was the incidence of shivering during the first 2 postoperative hours. Secondary variables were: shivering intensity, pain, postoperative nausea and vomiting, sedation, heart rate, non-invasive blood pressure and peripheral oxygen saturation. RESULTS: Shivering was less frequent in patients treated with tramadol (20% vs. 70%, P = 0.0009) and was of lower intensity (severe shivering: 10% vs. 46.7%, P = 0.003). Pain scores were similar between the groups and all other secondary outcome variables failed to reveal significant differences. CONCLUSIONS: Compared with placebo, intraoperative intravenous administration of 2 mg kg(-1) tramadol reduces the incidence and extent of postoperative shivering without alterations in pain perception after lumbar disc surgery under remifentanil-isoflurane-based general anaesthesia. SN - 1365-2346 UR - https://www.unboundmedicine.com/medline/citation/18289446/Intraoperative_tramadol_reduces_shivering_but_not_pain_after_remifentanil_isoflurane_general_anaesthesia__A_placebo_controlled_double_blind_trial_ L2 - http://dx.doi.org/10.1017/S0265021508003645 DB - PRIME DP - Unbound Medicine ER -