Tramadol – interaction with SSRIs and with Morphine

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RCT - addition of tramadol to morphine via PCA aftertotal knee arthroplasty(Stiller CO et al, Acta Anaesthesiol Scand 2007;51:322-30)Spinal anaesthesia63 patients randomisedVAS = 40/100Tramadol 100mg over 20 miniv every 6 h for 24h(total 400 mg/24 h)PCAmorphine B1mg; LO 6 min(Max 35mg/6h)VAS = 40/100Saline iv every6 h for 24 hVAS of pain, nausea, sedation - every hour for 6 h; priorto infusion of study drugs and 1 h after infusion; finalassessment at 24 h
Median (and interquartile range) of Average VAS afteradministration of tramadol 100mg 6 hourly for ‘intention to treat’population (Mo – morphine)(Stiller CO et al, Acta Anaesthesiol Scand 2007;51:322-30)no significant difference in pain intensity (sedation, nausea)
Page 2 and 3: Serotonin Syndrome (SS)• all drug
Page 4 and 5: Neuromuscular hyperactivityClonus,m
Page 6 and 7: Drugs associated with SerotoninToxi
Page 8 and 9: Cyproheptadine (5-HT 2Aantag)to red
Page 10 and 11: Tramadol and SSRIs• Tramadol - at
Page 13 and 14: Tramadoland Morphine• Multimodal
Page 15 and 16: TramadolCYP2D6(sparteineoxidase)250
Page 17: TramadolMorphine• Does combinatio
Page 21 and 22: Pain Intensity in Three groups by N
Page 23 and 24: Median Effective Dose of Tramadol a
Page 25 and 26: Mean (95% CI) Values for analgesic
Page 27 and 28: Mean Post-operative Pain Scores (±

Tramadol – interaction with SSRIs and with Morphine

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