Izvorni znanstveni članak

https://doi.org/10.20471/acc.2021.60.02.13

Analgesic Effect of Tramadol Is not Altered by Postoperative Systemic Inflammation after Major Abdominal Surgery

Nenad Nešković orcid.org/0000-0003-1160-163X ; Osijek University Hospital Centre, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Saška Marczi orcid.org/0000-0003-2110-3327 ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Osijek University Hospital Centre, Department of Transfusion Medicine, Laboratory of Molecular and HLA Diagnostics, Osijek, Croatia
Dario Mandić orcid.org/0000-0002-3792-4384 ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Osijek University Hospital Centre, Department of Clinical and Laboratory Diagnostics, Osijek, Croatia
Boris Mraovic orcid.org/0000-0003-4019-4084 ; University of Missouri, Department of Anesthesiology and Perioperative Medicine, School of Medicine, Columbia, USA
Sonja Škiljić ; Osijek University Hospital Centre, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Gordana Kristek orcid.org/0000-0002-4144-8077 ; Osijek University Hospital Centre, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Hrvoje Vinković ; Osijek University Hospital Centre, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Slavica Kvolik orcid.org/0000-0002-5244-9585 ; Osijek University Hospital Centre, Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia

Sažetak

Tramadol is a commonly used analgesic in intensive care units (ICUs) for acute
postoperative pain. Conversion of tramadol into active metabolites may be impaired in inflammatory
states. Catechol-O-methyltransferase may influence pain. The aim of the study was to examine differences
in the analgesic effect of tramadol between ICU patients with and without signs of systemic
inflammation. Forty-three patients were admitted to ICU after a major abdominal surgery. The patients
received a dose of 100 mg of tramadol intravenously every 6 hours during the first 24 hours
after surgical procedure. Pain scores were measured by the Numeric Rating Scale before and 30
minutes
after tramadol administration in awake patients. Systemic inflammation was considered
when at least two of the following postoperative parameters were present in the first 24 hours of ICU
admission: fever or hypothermia, tachycardia, pCO2 <4.3 kPa, white blood cells >12000/mm3 or
<4000/mm3, or preoperative value of C-reactive protein (CRP) >50 mg/L or/and procalcitonin (PCT)
>0.5 mg/L. Catechol-O-methyltransferase was analyzed postoperatively. Fifteen (34.8%) patients
met the criteria for systemic inflammation. Tramadol was proven to be an effective analgesic for the
treatment of postoperative pain regardless of the presence of systemic inflammation (p<0.05). Lower
perception of pain before tramadol application was observed in patients with systemic inflammation,
but the difference was not significant. A negative correlation was observed between the preoperative
values of CRP and PCT and the analgesic effect of tramadol assessed at the second measurement
point (r=-0.358, p=0.03, and r=-0.364, p=0.02, respectively). Catechol-O-methyltransferase variants
were not in correlation with pain and opioid consumption. Based on our findings, tramadol is effective
in lowering pain scores after major abdominal surgery irrespective of the presence of systemic inflammation.

Ključne riječi

Analgesia; Critical care; Systemic inflammatory response; Catechol-O-methyltransferase; Tramadol

Hrčak ID:

263707

URI

https://hrcak.srce.hr/263707

Datum izdavanja:

1.6.2021.

Podaci na drugim jezicima: hrvatski

Posjeta: 1.252 *