[Effect of tramadol adiministratian previous to induction of general anesthesia on prevention of postoperative shivering]

Shivering is a common post anesthetic complication. The relative efficacy of pharmacologic interventions used for the treatment of postoperative shivering is not well understood. The aim of this study was to evaluate the effect of administration of a 1mg/kg single dose Tramadol to induction of anesthesia in order to prevent post-anesthetic shivering. In this randomized, double-blind and placebo-controlled clinical trial, 60 patients which were classified based on American Association of Anesthesiologists [ASA] to physical status I or II selected for elective abdominal gynecologic surgeries by general anesthesia [GA]. Before induction of anesthesia, 30 patients [study group], received a single dose of 1 mg/kg intravenous Tramadol, and the other 30 patients [placebo group] recieved 0.9% saline. 3 patients [10%] of the study group and 17 patients [56.66%] of the placebo group experienced post anesthesia shivering [P<0.0001]. Incidence of pain in the immediate postoperative period was significantly higher in the placebo group [90% vs 23.33% of patients respectively; P<0.0001]. No significant difference was observed in the incidence of postoperative adverse effects between the two groups. This study supports administration of single dose of 1 mg/kg Tramadol, prior to induction of general anesthesia in prevention of postanesthetic shivering

[ effect of preoperative administration of tramadol on post-laparoscopic pain relief in women compared to placebo]

Tramadol is an analgesic with combined opioid agonist and monoamine reuptake blocker properties which may be useful as a preoperative analgesic and antinociceptive adjuvant. The aim of this study was the evaluation of preoperative tramadol administration on pain intensity, postoperative analgesic consumption and side effects compared to placebo. In this randomized, double-blind, placebo-controlled clinical trial 70 infertile, ASA class I or II patients were scheduled for diagnostic gynecologic laparoscopy. Fifty mg tramadol was injected into 35 patients before the operation and the other 35 patients received normal saline. The patients who received preoperative tramadol, had a lower pain score within six hours after the operation [1.31 +/- 0.94 compared to 2.93 +/- 0.55; p< 0.0001]. Ten patients [28.57%] in tramadol group and 33 patients in placebo group had post-operative pain [p< 0.0001]. The mean consumption of post-operative tramadol was statistically lower in treatment group [9.46 +/- 25.92] than in placebo group [45.95 +/- 37.96]; [p<0.0001]. Post- operative sedation level 15 minutes [p=0.71] and 30 minutes [p=0.88] after the operation had no significant difference between the two groups. The frequency of post-operative nausea in treatment group [5.71%] was significantly lower than placebo group [25.71%] ;[p=0.04]. Administration of a single dose of tramadol one hour before operation provides effective pre-emptive analgesia in patients undergoing diagnostic gynecologic laparoscopies without affecting sedation level

[Effect of small-dose of ephedrine administered prior to induction of anesthesia on the onset time of succinylcholine]

Onset of action of relaxants is influenced by cardiac output and muscle blood flow. Ephedrine increases blood flow to muscles and may shorten the onset of action of succinylcholine. The aim of the study was to evaluate the effect of small-dose of ephedrine administered prior to rapid-sequence induction of anesthesia on the onset time of succinylcholine for endotracheal intubation. In this randomized clinical trial, 50 patients scheduled for elective gynecologic surgeries in Alzahra hospital in Tabriz 1385, were selected. In these patients ephedrine, 70 micro g/kg [study group, n=30], or saline [placebo group, n=30] was administered 3 minutes before induction of anesthesia with thiopentone/fentanyl. Succinylcholine, 0.6 mg/kg, was administrated to facilitate the tracheal intubation. Onset of succinylcholine, intubating conditions and hemodynamic variables were recorded in the subjects. Fasciculation was absent in 60% [36] of the patients. No significant differences were found between the onsets of fasciculation between two groups. Moreover, the difference in duration of fasciculation in two groups was not significant. Onset time of succinylcholine was significantly shorter in study group [19.53 +/- 3.91second], compared with placebo group [25.87 +/- 7.11second] [p<0.0001]. Patients in study group were intubated in 47.07 +/- 4.51 seconds compared with 58.73 +/- 9.04 seconds in placebo group [p<0.0001]. Intubation conditions were similar in both groups. Heart rate was slightly increased in study patients in the first and 3rd minutes after ephedrine administration, but there was no significant difference in systolic blood pressure values compared with the baseline value between two groups. The onset time of succinylcholine is shortened with small-dose of ephedrine pretreatment without significant adverse heamodynamic effects