title: Analgesic and antacid properties of i.m. tramadol given before Caesarean section under general anaesthesia.
abstract: BACKGROUND
  Intramuscular (i.m.) tramadol increases gastric pH during anaesthesia similar to famotidine. We investigated the antacid analgesic value of a single dose of i.m. tramadol given 1 h before elective Caesarean section performed under general anaesthesia.
  
  
  METHODS
  Sixty ASA I parturients undergoing elective Caesarean section were included in a randomized double-blind study. The patients were randomly allocated to receive i.m. tramadol 100 mg (n=30) or famotidine 20 mg (n=30) 1 h before general anaesthesia.
  
  
  RESULTS
  At the beginning and the end of anaesthesia, patients receiving tramadol had a median gastric fluid pH of 6.4, which was not significantly different from those treated with famotidine (median 6.3). The infant well-being, as judged by Apgar score, cord blood gas analysis, and neurobehavioural assessment showed no significant difference between the two groups. Nalbuphine consumption in the first 24 h after operation was reduced by 35% in the tramadol group. Pain intensity score on sitting and sedation were significantly greater in famotidine group up to 24 h after surgery. There was no significant difference in incidence and severity of nausea and vomiting between the two groups.
  
  
  CONCLUSIONS
  A single i.m. dose of tramadol is useful pre-treatment to minimize the risk of acid aspiration during operation, and in improving pain relief during 24 h after surgery.
authors.affiliation: Department of Anaesthesia, Faculty of Medicine, Ain-Sham University, Cairo, Egypt. mokhtar.elhakim@gmail.com
authors.forename: M
authors.initials: M
authors.lastname: Elhakim
authors.forename: W
authors.initials: W
authors.lastname: Abd El-Megid
authors.forename: A
authors.initials: A
authors.lastname: Metry
authors.forename: A
authors.initials: A
authors.lastname: El-hennawy
authors.forename: K
authors.initials: K
authors.lastname: El-Queseny
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000768:Anesthesia, General / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000863:Antacids / Q000008:administration & dosage / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002585:Cesarean Section; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D015738:Famotidine / Q000627:therapeutic use; D005260:Female; D005745:Gastric Acidity Determination; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D007431:Intraoperative Complications / Q000517:prevention & control; D009266:Nalbuphine / Q000008:administration & dosage; D010149:Postoperative Pain / Q000517:prevention & control; D011015:Pneumonia, Aspiration / Q000517:prevention & control; D011229:Preanesthetic Medication; D011247:Pregnancy; D011256:Pregnancy Outcome; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D000863:Antacids; D000897:Anti-Ulcer Agents; D014147:Tramadol; D015738:Famotidine; D009266:Nalbuphine