Tramadol – interaction with SSRIs and with Morphine

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RCT- Effects of a single dose of tramadol prior to extubation onpost-operative pain and morphine consumption after coronaryartery bypass surgery(But AK et al, Acta Anaesthesiol Scand 2007;51:601-6)Similar anaesthesia (fentanyl 5 ug/kg;maintenance 30 ug/kg); propofol 1mg/kg/h topre-extubation)60 Patients randomisedinto two groupsGroup T - Tramadol 1mg/kg 1 h beforeextubationGroup P - 2 ml ofSaline 0.9% 1 hbefore extubationPCA (for 24h)morphine B1mg; LO 7 minMax 20mg/4h
Mean Post-operative Pain Scores (± SD), group P (Saline) vs.T(Tramadol) († p < 0.01 * p < 0.05) (plus morphine PCA)(But AK et al, Acta Anaesthesiol Scand 2007;51:601)pain scores significantly higher 1-4 h in group P[total morphine consumption reduced in group T over 24h (p < 0.01)]
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 and 18: TramadolMorphine• Does combinatio
Page 19 and 20: Median (and interquartile range) of
Page 21 and 22: Pain Intensity in Three groups by N
Page 23 and 24: Median Effective Dose of Tramadol a
Page 25: Mean (95% CI) Values for analgesic

Tramadol – interaction with SSRIs and with Morphine

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