The effect of tramadol plus paracetamol on consumption of morphine after coronary artery bypass grafting
| Autor: | Ayda Türköz, Özlem Çınar, Dilek Altun, Emre Özker |
|---|---|
| Přispěvatelé: | TÜRKÖZ, AYDA |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Sedation medicine.medical_treatment Placebo 03 medical and health sciences 0302 clinical medicine Bolus (medicine) Double-Blind Method 030202 anesthesiology medicine Humans Prospective Studies 030212 general & internal medicine Coronary Artery Bypass Tramadol Acetaminophen Aged Pain Measurement Postoperative Care Mechanical ventilation Pain Postoperative Morphine business.industry Analgesia Patient-Controlled Analgesics Non-Narcotic Middle Aged Surgery Cardiac surgery Analgesics Opioid Drug Combinations Anesthesiology and Pain Medicine Anesthesia Drug Therapy Combination Female medicine.symptom business medicine.drug Coronary intensive care |
| Zdroj: | Journal of Clinical Anesthesia. 36:189-193 |
| ISSN: | 0952-8180 |
| DOI: | 10.1016/j.jclinane.2016.10.030 |
| Popis: | To compare the effects of oral tramadol+paracetamol combination on morphine consumption following coronary artery bypass grafting (CABG) in the patient-controlled analgesia (PCA) protocol.A prospective, double-blind, randomized, clinical study.Single-institution, tertiary hospital.Fifty cardiac surgical patients undergoing primary CABG surgery.After surgery, the patients were allocated to 1 of 2 groups. Both groups received morphine according to the PCA protocol after arrival to the coronary intensive care unit (bolus 1 mg, lockout time 15 minutes). In addition to morphine administration 2 hours before operation and postoperative 2nd, 6th, 12th, 18th, 24th, 30th, 36th, 42th, and 48th hours, group T received tramadol+paracetamol (Zaldiar; 325 mg paracetamol, 37.5 mg tramadol) and group P received placebo. Sedation levels were measured with the Ramsay Sedation Scale, whereas pain was assessed with the Pain Intensity Score during mechanical ventilation and with the Numeric Rating Scale after extubation. If the Numeric Rating Scale score was ≥3 and Pain Intensity Score was ≥3, 0.05 mg/kg morphine was administered additionally.Preoperative patient characteristics, risk assessment, and intraoperative data were similar between the groups.Cumulative morphine consumption, number of PCA demand, and boluses were higher in group P (P.01). The amount of total morphine (in mg) used as a rescue analgesia was also higher in group P (5.06±1.0), compared with group T (2.37±0.52; P.001). The patients who received rescue doses of morphine were 8 (32%) in group T and 18 (72%) in group P (P.001). Duration of mechanical ventilation in group P was longer than group T (P.01).Tramadol+paracetamol combination along with PCA morphine improves analgesia and reduces morphine requirement up to 50% after CABG, compared with morphine PCA alone. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect