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Tramadol for postoperative pain therapy in infants - efficacy and side effects
s35
STUDlES ON THE NOClCEPTlVE DYSTROPHY (DMD).
CORRELATES
OF
DUCHENNE
MJM. Bajaj, Rajesh Kumaf and Vijay Raj Singh, lMuscular Research and Welfare Centre, Medical Physics Research ment of Physics & Astrophysics, University of Delhi, Delhi, AIM
of
OF
the
INVESTIGATION:
dystrophin
deficiency
MUSCULAR
Dystrophy Laboratory, (India).
and AIDS Depart-
Poster
21
GREY
Mon-Tues
Exhibit
Hall
Abs
64
No
The chief objective of the present work is to study the manifestations and pain perception in DMD using highly sophisticated techniques
of spectroscopy.
techniques for the study of the role of keratinlzation METHODS: We have used four spectroscopic AAS, FTIR, visibleand Laser Raman techniques. Blood, hair & process in DMD patients, namely, nails of DMD patients were taken and processed for spectroscopic studies. Serum was separated from the blood by centrifugation and erythrocytes were dehydrated in a desiccator over P2 05. All the DMD cases were thoroughly Diagnosis of DMD was based on clinical and symptomatic tests. screened by taking their detailed family histories. RESULTS: We find that a milder of different organs. The mobility were given to the afflicted patients
form of physiotherapy is helpful in obstructing of those patients was found to be maximum regularly by trained physiotherapists.
the where
deformrtles exercises
CONCLUSlON: It is concluded that the perception of pain is correlated with the molecular changes taking place due to the deficiency of 0.427 megadalton dystrophin having 3685 encoded amino acids and insertion of dystrophin prepared synthetically or obtained from animal kingdom is likely to be a possible mode of interference in the nociceptive network of the DMD patients. Biochemical synthesis
of
the
DMD
gene
product
ought
to be one of the
chief
objectives
of the
TRAMADOL FOR POSTOPERATIVE PAIN THERAPY IN INFANTS - EFFICACY AND SIDE EFFECTS. ‘. * , H. Hagemann*, S. Piepenbrock* (SPON: B. Kossmann), Dep. J. Schaffer of Anesthesiology II, Hannover Medical School, D-3000 Hannover 61, W.Germany
DMD
management.
GREY
Mon-Tues
Exhibit
Hall
AIM OF THE INVESTIGU: Postoperative pain treatment is often only inadequately performed in infants. The present study therefore examines the opioid Tramadol to determine its effects and side effects for this indication. After minor interventions in pediatric surgery, infants (lo-22 kg body METHODS: weight) received either 1 mg/kg b.w. (Group 1) or 2 mg/kg b.w. (Group 2) of tramadol as soon as they had pain iv. in a randomized and double-blind manner. Over a period of 6 hours, the pain and the degree of sedation were assessed by visual analog scales, and the changes in heart rate, blood pressure and respiratory rate were registered. The pCO2 was transcutaneously measured in 11 patients of Group 1 and 12 of Group 2. Moreover, any side effects that occurred were also recorded. The intensity of pain was lower in both groups at all times than prior to RESULTS injection and, in the first 60 min, was lower after 2 mg/kg b.w. than after 1 mg/kg b.w. of tramadol. After 60 min, the infants of both groups were more conscious than before the analgesic injection. The heart rate and the respiratory rate decreased in the course of the examination period compared to initial values but, like the blood pressure, did not differ between the two groups. Following 2 mg/kg b.w. of tramadol, transcutaneously measured pCO2 was lower than the initial value (41.3 + 1.94 mmHg (x * SEM)) after 30 (36.8 + 1.96 mmHg (x + SEM)) and 40 (36.8 r 1.96 mmHg (x x SEM)) minutes; there was no difference between the two groups. The most frequent side effects were tiredness in 4 infants each and nausea and vomiting in 4 infants after the low dosage and in 3 after the high one. The results show that better postoperative analgesia can be achieved in CONCLUSIONS infants with 2 mg/kg b.w. than with 1 mg/kg b.w. of tramadol i.v. Hemodynamic and respiratory alterations emphaxise these results. Intravenous application, however, is restricted in infants by the fact that too rapid injection nearly always leads to vomiting; regarding previous studies we would therefore prefer the intramuscular injection.
STUDlES ON THE NOClCEPTlVE DYSTROPHY (DMD).
CORRELATES
OF
DUCHENNE
MJM. Bajaj, Rajesh Kumaf and Vijay Raj Singh, lMuscular Research and Welfare Centre, Medical Physics Research ment of Physics & Astrophysics, University of Delhi, Delhi, AIM
of
OF
the
INVESTIGATION:
dystrophin
deficiency
MUSCULAR
Dystrophy Laboratory, (India).
and AIDS Depart-
Poster
21
GREY
Mon-Tues
Exhibit
Hall
Abs
64
No
The chief objective of the present work is to study the manifestations and pain perception in DMD using highly sophisticated techniques
of spectroscopy.
techniques for the study of the role of keratinlzation METHODS: We have used four spectroscopic AAS, FTIR, visibleand Laser Raman techniques. Blood, hair & process in DMD patients, namely, nails of DMD patients were taken and processed for spectroscopic studies. Serum was separated from the blood by centrifugation and erythrocytes were dehydrated in a desiccator over P2 05. All the DMD cases were thoroughly Diagnosis of DMD was based on clinical and symptomatic tests. screened by taking their detailed family histories. RESULTS: We find that a milder of different organs. The mobility were given to the afflicted patients
form of physiotherapy is helpful in obstructing of those patients was found to be maximum regularly by trained physiotherapists.
the where
deformrtles exercises
CONCLUSlON: It is concluded that the perception of pain is correlated with the molecular changes taking place due to the deficiency of 0.427 megadalton dystrophin having 3685 encoded amino acids and insertion of dystrophin prepared synthetically or obtained from animal kingdom is likely to be a possible mode of interference in the nociceptive network of the DMD patients. Biochemical synthesis
of
the
DMD
gene
product
ought
to be one of the
chief
objectives
of the
TRAMADOL FOR POSTOPERATIVE PAIN THERAPY IN INFANTS - EFFICACY AND SIDE EFFECTS. ‘. * , H. Hagemann*, S. Piepenbrock* (SPON: B. Kossmann), Dep. J. Schaffer of Anesthesiology II, Hannover Medical School, D-3000 Hannover 61, W.Germany
DMD
management.
GREY
Mon-Tues
Exhibit
Hall
AIM OF THE INVESTIGU: Postoperative pain treatment is often only inadequately performed in infants. The present study therefore examines the opioid Tramadol to determine its effects and side effects for this indication. After minor interventions in pediatric surgery, infants (lo-22 kg body METHODS: weight) received either 1 mg/kg b.w. (Group 1) or 2 mg/kg b.w. (Group 2) of tramadol as soon as they had pain iv. in a randomized and double-blind manner. Over a period of 6 hours, the pain and the degree of sedation were assessed by visual analog scales, and the changes in heart rate, blood pressure and respiratory rate were registered. The pCO2 was transcutaneously measured in 11 patients of Group 1 and 12 of Group 2. Moreover, any side effects that occurred were also recorded. The intensity of pain was lower in both groups at all times than prior to RESULTS injection and, in the first 60 min, was lower after 2 mg/kg b.w. than after 1 mg/kg b.w. of tramadol. After 60 min, the infants of both groups were more conscious than before the analgesic injection. The heart rate and the respiratory rate decreased in the course of the examination period compared to initial values but, like the blood pressure, did not differ between the two groups. Following 2 mg/kg b.w. of tramadol, transcutaneously measured pCO2 was lower than the initial value (41.3 + 1.94 mmHg (x * SEM)) after 30 (36.8 + 1.96 mmHg (x + SEM)) and 40 (36.8 r 1.96 mmHg (x x SEM)) minutes; there was no difference between the two groups. The most frequent side effects were tiredness in 4 infants each and nausea and vomiting in 4 infants after the low dosage and in 3 after the high one. The results show that better postoperative analgesia can be achieved in CONCLUSIONS infants with 2 mg/kg b.w. than with 1 mg/kg b.w. of tramadol i.v. Hemodynamic and respiratory alterations emphaxise these results. Intravenous application, however, is restricted in infants by the fact that too rapid injection nearly always leads to vomiting; regarding previous studies we would therefore prefer the intramuscular injection.