Titre du document / Document title

A comparison of the effects of intravenous tramadol, codeine, and morphine on gastric emptying in human volunteers

Auteur(s) / Author(s)

CRIGHTON I. M. ⁽¹⁾ ; MARTIN P. H. ⁽¹⁾ ; HOBBS G. J. ⁽¹⁾ ; COBBY T. F. ⁽¹⁾ ; FLETCHER A. J. P. ⁽¹⁾ ; STEWART P. D. ⁽¹⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ University Department of Anaesthesia, Queen's Medical Centre, Nottingham, ROYAUME-UNI

Résumé / Abstract

We compared the effects of IV tramadol (1.25 mg/kg), codeine (1 mg/kg), morphine (0.125 mg/kg), and saline on gastric emptying in 10 healthy human volunteers using a double-blind, randomized, cross-over design. Subjects received one treatment at each of four sessions, 2 wk apart. Gastric emptying was studied using the paracetamol absorption test. There were significant differences when comparing all treatments for concentration-time data (P = 0.002), peak serum paracetamol concentrations (Cmax; P < 0.001), times at Cmax (Tmax; P = 0.003), and areas under the curves from Time 0 to 360 min (AUC₀ -360; P = 0.049). Morphine profoundly inhibited gastric emptying. Tramadol had measurable but statistically insignificant inhibitory effects on gastric emptying compared with saline (mean ± SEM: Cmax 22.4 ± 2.2 vs 26.8 ± 2.5 mg/L [P = 0.19], Tmax 33 ± 5.4 vs 19.5 ± 2.3 min [P = 0.054] for tramadol versus saline, respectively). Compared with morphine, the Cmax (P < 0.01), Tmax, and AUC_0- 360 (P < 0.05) values for tramadol were significantly different. The Tmax value for codeine (63.3 ± 11.7) was greater than that for tramadol (P = 0.034). We conclude that tramadol has a measurable but smaller inhibitory effect on gastric emptying compared with other opioids. Implications: We compared the effect of tramadol, an unconventional opioid painkiller, on stomach emptying with that of codeine and morphine in a human volunteer study. Tramadol had a measurable but smaller effect and may have clinical and economic advantages in acute pain management compared with conventional painkillers.

Revue / Journal Title

Anesthesia and analgesia   ISSN 0003-2999   CODEN AACRAT 

Source / Source

1998, vol. 87, n^o2, pp. 445-449 (27 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott, Hagerstown, MD, ETATS-UNIS  (1957) (Revue)

Mots-clés anglais / English Keywords

Tramadol ; Morphine ; Intravenous administration ; Comparative study ; Gastric emptying ; Human ; Normal ; Biological activity ; Opiates ; Narcotic analgesic ; Digestive system ;

Mots-clés français / French Keywords

Tramadol ; Codéine ; Morphine ; Voie intraveineuse ; Etude comparative ; Evacuation gastrique ; Homme ; Normal ; Activité biologique ; Opiacés ; Analgésique narcotique ; Appareil digestif ;

Mots-clés espagnols / Spanish Keywords

Tramadol ; Morfina ; Vía intravenosa ; Estudio comparativo ; Vaciamiento gástrico ; Hombre ; Normal ; Actividad biológica ; Opiados ; Analgésico narcotico ; Aparato digestivo ;

Localisation / Location

INIST-CNRS, Cote INIST : 3213, 35400007266324.0400