Analgesic and antacid properties of i.m. tramadol given before Caesarean section under general anaesthesia.
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.
Elhakim
M
M
Department of Anaesthesia, Faculty of Medicine, Ain-Sham University, Cairo, Egypt. mokhtar.elhakim@gmail.com
Abd El-Megid
W
W
Metry
A
A
El-hennawy
A
A
El-Queseny
K
K
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*
D000701:Analgesics, Opioid; D000863:Antacids; D000897:Anti-Ulcer Agents; D014147:Tramadol; D015738:Famotidine; D009266:Nalbuphine