Effects of Systemic or Adjunct Tramadol Addition to Lidocaine Used for IVRA in Patients Undergoing Hand Surgery

Summary

Intravenous regional anesthesia (IVRA) is used in outpatient hand surgery as an easily applicable and cost-effective technique with clinical advantages. Nevertheless, IVRA has some disadvantages including anesthetic toxicity, slow-onset, poor muscle relaxation, tourniquet pain, and minimal postoperative pain relief. Providing an ideal anesthesia by overcoming these disadvantages is possible with the addition of some adjunct agents into local anesthetic substances. One of these adjunct agents used for IVRA is tramadol, a synthetic analgesic having opioid and nonopioid characteristics. The present study aimed to investigate the effects of addition of systemic tramadol or adjunct tramadol to lidocaine for IVRA in patients undergoing hand surgery..

Timeline

Start

2013-01

Primary completion

2013-06

Completion

2013-08

Publications

• Background Chan VW, Peng PW, Kaszas Z, Middleton WJ, Muni R, Anastakis DG, Graham BA. A comparative study of general anesthesia, intravenous regional anesthesia, and axillary block for outpatient hand surgery: clinical outcome and cost analysis. Anesth Analg. 2001 Nov;93(5):1181-4. doi: 10.1097/00000539-200111000-00025.
• Background dos Reis A Jr. Intravenous regional anesthesia--first century (1908-2008). Beggining, development, and current status. Rev Bras Anestesiol. 2008 May-Jun;58(3):299-321. doi: 10.1590/s0034-70942008000300013. English, Portuguese.
• Background Choyce A, Peng P. A systematic review of adjuncts for intravenous regional anesthesia for surgical procedures. Can J Anaesth. 2002 Jan;49(1):32-45. doi: 10.1007/BF03020416.
• Background Vazzana M, Andreani T, Fangueiro J, Faggio C, Silva C, Santini A, Garcia ML, Silva AM, Souto EB. Tramadol hydrochloride: pharmacokinetics, pharmacodynamics, adverse side effects, co-administration of drugs and new drug delivery systems. Biomed Pharmacother. 2015 Mar;70:234-8. doi: 10.1016/j.biopha.2015.01.022. Epub 2015 Feb 7.
• Background Pang WW, Mok MS, Chang DP, Huang MH. Local anesthetic effect of tramadol, metoclopramide, and lidocaine following intradermal injection. Reg Anesth Pain Med. 1998 Nov-Dec;23(6):580-3. doi: 10.1016/s1098-7339(98)90085-2.
• Background Pang WW, Huang PY, Chang DP, Huang MH. The peripheral analgesic effect of tramadol in reducing propofol injection pain: a comparison with lidocaine. Reg Anesth Pain Med. 1999 May-Jun;24(3):246-9. doi: 10.1016/s1098-7339(99)90136-0.
• Background Sousa AM, Ashmawi HA, Costa LS, Posso IP, Slullitel A. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models. Braz J Med Biol Res. 2012 Feb;45(2):147-52. doi: 10.1590/s0100-879x2011007500164. Epub 2011 Dec 23.
• Background Kapral S, Gollmann G, Waltl B, Likar R, Sladen RN, Weinstabl C, Lehofer F. Tramadol added to mepivacaine prolongs the duration of an axillary brachial plexus blockade. Anesth Analg. 1999 Apr;88(4):853-6. doi: 10.1097/00000539-199904000-00032.
• Background Nagpal V, Rana S, Singh J, Chaudhary SK. Comparative study of systemically and perineurally administered tramadol as an adjunct for supraclavicular brachial plexus block. J Anaesthesiol Clin Pharmacol. 2015 Apr-Jun;31(2):191-5. doi: 10.4103/0970-9185.155147.
• Background Bigat Z, Boztug N, Hadimioglu N, Cete N, Coskunfirat N, Ertok E. Does dexamethasone improve the quality of intravenous regional anesthesia and analgesia? A randomized, controlled clinical study. Anesth Analg. 2006 Feb;102(2):605-9. doi: 10.1213/01.ane.0000194944.54073.dd.
• Background Kashefi P, Montazeri K, Honarmand A, Safavi M, Hosseini HM. The analgesic effect of midazolam when added to lidocaine for intravenous regional anaesthesia. J Res Med Sci. 2011 Sep;16(9):1139-48.
• Background Khanna P, Mohan VK, Sunder RA. Efficacy of diltiazem as an adjunct to lignocaine in intravenous regional anesthesia. Saudi J Anaesth. 2013 Jul;7(3):305-9. doi: 10.4103/1658-354X.115359.
• Background Memis D, Turan A, Karamanlioglu B, Pamukcu Z, Kurt I. Adding dexmedetomidine to lidocaine for intravenous regional anesthesia. Anesth Analg. 2004 Mar;98(3):835-40, table of contents. doi: 10.1213/01.ane.0000100680.77978.66.
• Background Sen H, Kulahci Y, Bicerer E, Ozkan S, Dagli G, Turan A. The analgesic effect of paracetamol when added to lidocaine for intravenous regional anesthesia. Anesth Analg. 2009 Oct;109(4):1327-30. doi: 10.1213/ane.0b013e3181b0fedb.
• Background Sen S, Ugur B, Aydin ON, Ogurlu M, Gezer E, Savk O. The analgesic effect of lornoxicam when added to lidocaine for intravenous regional anaesthesia. Br J Anaesth. 2006 Sep;97(3):408-13. doi: 10.1093/bja/ael170. Epub 2006 Jul 15.
• Background Sertoz N, Kocaoglu N, Ayanoglu HO. Comparison of lornoxicam and fentanyl when added to lidocaine in intravenous regional anesthesia. Braz J Anesthesiol. 2013 Jul-Aug;63(4):311-6. doi: 10.1016/j.bjane.2012.07.001. Epub 2013 Aug 13.
• Background Sen S, Ugur B, Aydin ON, Ogurlu M, Gursoy F, Savk O. The analgesic effect of nitroglycerin added to lidocaine on intravenous regional anesthesia. Anesth Analg. 2006 Mar;102(3):916-20. doi: 10.1213/01.ane.0000195581.74190.48.
• Background Turan A, Memis D, Karamanlioglu B, Guler T, Pamukcu Z. Intravenous regional anesthesia using lidocaine and magnesium. Anesth Analg. 2005 Apr;100(4):1189-1192. doi: 10.1213/01.ANE.0000145062.39112.C5.
• Background Viscomi CM, Friend A, Parker C, Murphy T, Yarnell M. Ketamine as an adjuvant in lidocaine intravenous regional anesthesia: a randomized, double-blind, systemic control trial. Reg Anesth Pain Med. 2009 Mar-Apr;34(2):130-3. doi: 10.1097/AAP.0b013e31819bb006.
• Background Acalovschi I, Cristea T, Margarit S, Gavrus R. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg. 2001 Jan;92(1):209-14. doi: 10.1097/00000539-200101000-00040.
• Background Aslan B, Izdes S, Kesimci E, Gumus T, Kanbak O. [Comparison of the effects of lidocaine, lidocaine plus tramadol and lidocaine plus morphine for intravenous regional anesthesia]. Agri. 2009 Jan;21(1):22-8. Turkish.
• Background Alayurt S, Memis D, Pamukcu Z. The addition of sufentanil, tramadol or clonidine to lignocaine for intravenous regional anaesthesia. Anaesth Intensive Care. 2004 Feb;32(1):22-7. doi: 10.1177/0310057X0403200103.
• Background Langlois G, Estebe JP, Gentili ME, Kerdiles L, Mouilleron P, Ecoffey C. The addition of tramadol to lidocaine does not reduce tourniquet and postoperative pain during iv regional anesthesia. Can J Anaesth. 2002 Feb;49(2):165-8. doi: 10.1007/BF03020489.
• Background Tan SM, Pay LL, Chan ST. Intravenous regional anaesthesia using lignocaine and tramadol. Ann Acad Med Singap. 2001 Sep;30(5):516-9.
• Background Siddiqui AK, Mowafi HA, Al-Ghamdi A, Ismail SA, AbuZeid HA. Tramadol as an adjuvant to intravenous regional anesthesia with lignocaine. Saudi Med J. 2008 Aug;29(8):1151-5.
• Background Flamer D, Peng PW. Intravenous regional anesthesia: a review of common local anesthetic options and the use of opioids and muscle relaxants as adjuncts. Local Reg Anesth. 2011;4:57-76. doi: 10.2147/LRA.S16683. Epub 2011 Nov 25.
• Background Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet. 2004;43(13):879-923. doi: 10.2165/00003088-200443130-00004.

Drugs

Indications

No indication recorded.