title: Does tramadol affect coagulation status of patients with malignancy?
abstract: OBJECTIVE
  The study investigated the direct effects of tramadol on the coagulation status of women with gynecologic malignancies in vitro.
  
  
  METHODS
  Citrated whole-blood samples from 21 patients with gynecologic tumors were spiked ex vivo with 2 or 6 μl/ml tramadol. Thrombelastography (TEG) analysis was performed using ROTEM(®) to assess clotting time (CT), clot formation time (CFT) and maximum clot formation (MCF).
  
  
  RESULTS
  In the INTEM assay, CT (P < 0.05) and CFT (P < 0.01) were significantly prolonged with tramadol at a 6 μl/ml concentration compared with baseline. There were no significant differences in MCF values between the baseline and the tramadol-treated samples (P > 0.05). Blood medicated with tramadol (6 μl/ml) clotted slowly (increased CT and CFT).
  
  
  CONCLUSIONS
  The changes observed by TEG demonstrated that tramadol impairs hemostasis in a concentration-dependent manner in the whole blood of women with gynecologic malignancies in vitro.
authors.affiliation: Department of Anaesthesiology and Reanimation, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey.
authors.forename: Ayten
authors.initials: A
authors.lastname: Bilir
authors.affiliation: Department of Hematology, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey.
authors.forename: Meltem Olga
authors.initials: MO
authors.lastname: Akay
authors.affiliation: Department of Anaesthesiology and Reanimation, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Ceyhan
authors.affiliation: Department of Hematology, Eskisehir Osmangazi University Medical School, Eskisehir, Turkey.
authors.forename: Neslihan
authors.initials: N
authors.lastname: Andıc
mesh_terms: D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001777:Blood Coagulation / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D016889:Endometrial Neoplasms / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D013916:Thrombelastography; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002583:Uterine Cervical Neoplasms / Q000097:blood* / Q000188:drug therapy
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol
keywords: Coagulation; malignancy; thromboelastography; tramadol
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