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期刊论文 2

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2012 2

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Estimation of the minimum effective dose of tramadol for postoperative analgesia in infants using the

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《医学前沿(英文)》 2012年 第6卷 第3期   页码 288-295 doi: 10.1007/s11684-012-0208-4

摘要:

Tramadol is a potent analgesic. However, the analgesia efficacy of tramadol, particularly its minimum effective dose (MED), is not clear. The aim of this study is to find MED of tramadol for postoperative analgesia in infants. The continual reassessment method (CRM) was performed to find MED. Infants undergoing surgeries were included in the 3 phases of this series. In each phase, 24 participants were allocated a different tramadol dose. Pain intensity was measured by face, legs, activity, cry, consolability (FLACC) measurement at 3-hour intervals. Tramadol was considered ineffective if the FLACC score was higher than 4 in 10 at anytime. In phase 1, seven dose levels were used within the range 0.1–0.4 mg?kg-1·h-1. Phase 1 was insufficient to identify the MED, and we increased the dose to 0.4–0.8 mg?kg-1·h-1 in phase 2. Phase 2 was insufficient to identify the MED. In phase 3, local anesthetic wound infiltration was introduced, and the tramadol dose levels tested were the same as in phase 1. The successful analgesia probability of tramadol 0.4 mg?kg-1?h-1 was 82.1% (95% CI, 0.742–0.925) in phase 1. In phase 2, it was 84.7% (95% CI, 0.789–0.991) with the dose 0.8 mg?kg-1?h-1. Phase 1 and phase 2 were insufficient to identify the MED. In phase 3, the successful analgesia probability for dose 0.35 mg?kg-1?h-1was 96.7% (95% CI, 0.853–0.997).We have demonstrated that tramadol provides insufficient analgesia for surgeries considered to cause moderate-to-severe postoperative pain in infants if used as the sole analgesic, and that local anesthetic wound infiltration enhances the efficacy of tramadol.

关键词: tramadol     minimum effective dose     postoperative analgesia     infants     continual reassessment method    

Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

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《医学前沿(英文)》 2012年 第6卷 第4期   页码 411-415 doi: 10.1007/s11684-012-0226-2

摘要:

Ketamine exerts rapid and robust antidepressant properties in both animal models and depressed patients and tramadol possesses potential antidepressant effects. Brain-derived neurotrophic factor (BDNF) is an important biomarker for mood disorders and tropomyosin-related kinase B (TrkB) is a high affinity catalytic receptor for BDNF. We hypothesized that tramadol pretreatment might reinforce ketamine-elicited antidepressant effects with significant changes in hippocampal BDNF and TrkB levels in rats. Immobility time of rats receiving different treatment in the forced swimming test (FST) was observed. Levels of BDNF and TrkB in hippocampus were measured by enzyme linked immunosorbent assay. Results showed that tramadol (5 mg/kg) administrated alone neither elicited antidepressant effects nor altered BDNF or TrkB level. However, pretreatment with tramadol (5 mg/kg) enhanced the ketamine (10 mg/kg) -elicited antidepressant effects and upregulated the BDNF and TrkB levels in hippocampus. In conclusion, tramadol pretreatment reinforces the ketamine-elicited antidepressant effects, which is associated with the increased levels of BDNF and TrkB in rat hippocampus.

关键词: tramadol     ketamine     antidepressant     brain-derived neurotrophic factor     tropomyosin-related kinase B    

标题 作者 时间 类型 操作

Estimation of the minimum effective dose of tramadol for postoperative analgesia in infants using the

null

期刊论文

Tramadol reinforces antidepressant effects of ketamine with increased levels of brain-derived neurotrophic

null

期刊论文