• Anesthesia and analgesia · May 2001

    Clinical Trial Controlled Clinical Trial

    The analgesic efficacy of tramadol is impaired by concurrent administration of ondansetron.

    • J L De Witte, B Schoenmaekers, D I Sessler, and T Deloof.
    • Department of Anesthesia and Intensive Care, OLV-Hospital, Aalst, Belgium. jan.de.witte@olvz-aalst.be
    • Anesth. Analg. 2001 May 1;92(5):1319-21.

    AbstractTramadol has weak opioid properties, and an analgesic effect that is mediated mainly by inhibition of the reuptake of norepinephrine and serotonin (5-hydroxytryptamine [5-HT]) and facilitation of 5-HT release (1,2) at the spinal cord. Because 5-HT3 receptors play a key role in pain transmission at the spinal level (3), the 5-HT3 antagonist ondansetron may decrease the efficacy of tramadol, as suggested in an abstract by Maroof et al. In that study, a small dose of 1 mg/kg tramadol was administered along with ondansetron 0.1 mg/kg or placebo, 15 min before the induction of anesthesia. Early postoperative pain scored differed significantly between the test groups. We therefore tested the hypothesis that the tramadol requirement by patient-controlled analgesia (PCA) may be increased when ondansetron is administered for antiemetic prophylaxis.

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