The impact of caudally administrated tramadol on immune response and analgesic efficacy for pediatric patients: a comparative randomized clinical trial
10.3344/kjp.2018.31.3.206
- Author:
Jehan Ahmed SAYED
1
;
Sayed Kaoud ABD ELSHAFY
;
Emad Zareif KAMEL
;
Mohamed Amir FATHY RIAD
;
Amal Ahmed MAHMOUD
;
Ghada Shalaby KHALAF
Author Information
1. Department of Anesthesia, College of Medicine, Assiut University, Assiut, Egypt. sayed_k_72@yahoo.com
- Publication Type:Clinical Trial
- Keywords:
Abdomen;
Caudal anesthesia;
C-reactive protein;
Cytokine;
Differential leukocyte count;
Immune response;
Interleukin 6;
Leukocytes;
Surgery;
Pediatrics;
Tramadol;
Post-operative pain
- MeSH:
Abdomen;
Analgesics;
Anesthesia;
Anesthesia, Caudal;
Anesthetics;
Bupivacaine;
C-Reactive Protein;
Child;
Humans;
Hydrocortisone;
Interleukin-6;
Interleukins;
Leukocyte Count;
Leukocytes;
Leukocytosis;
Lymphocytes;
Monocytes;
Neutrophils;
Pain Management;
Pain, Postoperative;
Pediatrics;
Tramadol;
Weights and Measures
- From:The Korean Journal of Pain
2018;31(3):206-214
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Immune responses appear to be affected by anesthetics and analgesics. We investigated the effects of caudal tramadol on the postoperative immune response and pain management in pediatric patients. METHODS: Sixty ASA-I pediatric patients aged 3–10 years undergoing lower abdominal surgery. Patients were randomly assigned either to a caudal bupivacaine (0.25%) group (group B), or a group that received caudal tramadol (1 mg/kg) added to the bupivacaine (0.25%) (group T). Both were diluted in a 0.9% NaCl solution to a total volume of 1ml/kg. The systemic immune response was measured by collecting blood samples preoperatively, at the end of anesthesia, and at 24 and 72 hours postoperatively, and studied for interleukin IL-6, C-reactive proteins (CRP) cortisol levels, and leucocytes with its differential count. Postoperative pain was assessed along with sedation scales. RESULTS: Postoperative production of IL-6 was significantly higher in group B at the end of anesthesia, than at the 24th hour, and at the 72nd hour in group B and group T, respectively. The immune response showed leukocytosis with increased percentages of neutrophil and monocytes, and a decreased lymphocyte response rate within both groups with no significant differences between the groups. Cortisol and CRP were significantly higher in group B. CONCLUSIONS: Adding tramadol to a caudal bupivacaine block can attenuate the pro-inflammatory cytokine response, Cortisol, and CRP in children undergoing lower abdominal surgery.
