The Relationship Between Tramadol Use and Cardio Electrophysiological Balance for Postoperative Pain Treatment in General Surgery Patients
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Population
2.2. Electrocardiography
2.3. Statistical Analysis
3. Results
4. Discussion
Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Sacerdote, P.; Coluzzi, F.; Fanelli, A. Sublingual sufentanil, a new opportunity for the improvement of postoperative pain management in Italy. Eur. Rev. Med. Pharmacol. Sci. 2016, 20, 1411–1422. [Google Scholar] [PubMed]
- Coccolini, F.; Corradi, F.; Sartelli, M.; Coimbra, R.; Kryvoruchko, I.A.; Leppaniemi, A.; Doklestic, K.; Bignami, E.; Biancofiore, H.; Bala, M.; et al. Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines. World J. Emerg. Surg. 2022, 17, 50. [Google Scholar] [CrossRef] [PubMed]
- Kaya, A.; Usta, B. Comparison the efficacy of intravenous and topical tramadol on postoperative pain control after septoplasty. Int. J. Curr. Med. Biol. Sci. 2023, 3, 104–110. [Google Scholar]
- Emamhadi, M.; Sanaei-Zadeh, H.; Nikniya, M.; Zamani, N.; Dart, R.C. Electrocardiographic manifestations of tramadol toxicity with special reference to their ability for prediction of seizures. Am. J. Emerg. Med. 2012, 30, 1481–1485. [Google Scholar] [CrossRef] [PubMed]
- Chen, A.; Ashburn, M.A. Cardiac Effects of Opioid Therapy. Pain. Med. 2015, 16, 27–31. [Google Scholar] [CrossRef]
- Massarella, J.; Ariyawansa, J.; Natarajan, J.; Francke, S.; Murtaugh, T.; DeLemos, B.; Vaughan, S.; Fonseca, S. Tramadol Hydrochloride at Steady State Lacks Clinically Relevant QTc Interval Increases in Healthy Adults. Clin. Pharmacol. Drug Dev. 2019, 8, 95–106. [Google Scholar] [CrossRef]
- Behzadi, M.; Joukar, S.; Beik, A. Opioids and Cardiac Arrhythmia: A Literature Review. Med. Princ. Pract. 2018, 27, 401–414. [Google Scholar] [CrossRef]
- Ghamsari, A.A.; Dadpour, B.; Najari, F. Frequency of Electrocardiographic Abnormalities in Tramadol Poisoned Patients; a Brief Report. Emergency 2016, 4, 151–154. [Google Scholar]
- Omraninava, A.; Mehdizade, A.; Karimi, E.; Ghabousian, A. Potential Impact of 3% Hypertonic Saline Infusion on Tramadol Poisoning-Induced Electrocardiogram Changes; a Randomized Clinical Trial. Arch. Acad. Emerg. Med. 2022, 10, e26. [Google Scholar]
- Keller, G.A.; Etchegoyen, M.C.; Fernandez, N.; Olivera, N.M.; Quiroga, P.N.; Belloso, W.H.; Diez, R.A.; Di Girolamo, G. Tramadol Induced QTc-Interval Prolongation: Prevalence, Clinical Factors and Correlation to Plasma Concentrations. Curr. Drug Saf. 2016, 11, 206–214. [Google Scholar] [CrossRef]
- Moghadam, P.H.; Zarei, N.; Farsi, D.; Abbasi, S.; Mofidi, M.; Rezai, M.; Mahshidfar, B. Electrocardiographic changes in patients with tramadol-induced idiosyncratic seizures. Turk. J. Emerg. Med. 2016, 16, 151–154. [Google Scholar] [CrossRef] [PubMed]
- Guzelcicek, A.; Kilinc, E.; Fedai, H.; Dedeoglu, N.F.; Toprak, K.; Tascanov, M.B.; Ocak, M.; Gungorer, B.; Kose, D. Relationship between Vitamin D Level and Index of Cardio Electrophysiological Balance in Children. Comb. Chem. High Throughput Screen. 2024, 27, 2096–2100. [Google Scholar] [CrossRef] [PubMed]
- Sivri, S.; Çelik, M. Evaluation of index of cardiac-electrophysiological balance before and after hemodialysis in patients with end-stage renal disease. J. Electrocardiol. 2019, 54, 72–75. [Google Scholar] [CrossRef] [PubMed]
- Ozturk, U.; Ozturk, O. Index of cardio-electrophysiological balance and Parkinson disease. Medicine 2023, 102, e35075. [Google Scholar] [CrossRef] [PubMed]
- Mulita, F.; Karpetas, G.; Liolis, E.; Vailas, M.; Tchabashvili, L.; Maroulis, I. Comparison of analgesic efficacy of acetaminophen monotherapy versus acetaminophen combinations with either pethidine or parecoxib in patients undergoing laparoscopic cholecystectomy: A randomized prospective study. Med. Glas. 2021, 18, 27–32. [Google Scholar] [CrossRef] [PubMed]
- Askin, L.; Tanrıverdi, O. Evaluation of index of cardio-electrophysiological balance in patients with coronary slow flow. Acta Cardiol. 2022, 77, 337–341. [Google Scholar] [CrossRef]
- Tascanov, M.B.; Havlioglu, S.; Tanriverdi, Z.; Gungoren, F.; Altiparmak, İ.H. Effect of noise on the electrocardiographic parameters. Int. Arch. Occup. Environ. Health 2021, 94, 1397–1403. [Google Scholar] [CrossRef]
- İnci, Ü.; Güzel, T. The effect of empagliflozin on index of cardio-electrophysiological balance in patients with diabetes mellitus. Pacing Clin. Electrophysiol. 2023, 46, 44–49. [Google Scholar] [CrossRef]
- Beakley, B.D.; Kaye, A.M.; Kaye, A.D. Tramadol, Pharmacology, Side Effects, and Serotonin Syndrome: A Review. Pain Physician 2015, 18, 395–400. [Google Scholar]
- Jia, L.; Veldkamp, M.W.; Verkerk, A.O.; Tan, H.L. The opioid tramadol blocks the cardiac sodium channel Nav1.5 in HEK293 cells. Europace 2023, 25, euad209. [Google Scholar] [CrossRef]
- Eroglu, T.E.; Barcella, C.A.; Gerds, T.A.; Kessing, L.V.; Zylyftari, N.; Mohr, G.H.; Kragholm, K.; Polcwiartek, C.; Wissenberg, M.; Folke, F.; et al. Risk of out-of-hospital cardiac arrest in antidepressant drug users. Br. J. Clin. Pharmacol. 2022, 88, 3162–3171. [Google Scholar] [CrossRef] [PubMed]
- Jia, L.; Eroglu, T.E.; Wilders, R.; Verkerk, A.O.; Tan, H.L. Carbamazepine Increases the Risk of Sudden Cardiac Arrest by a Reduction of the Cardiac Sodium Current. Front. Cell Dev. Biol. 2022, 10, 891996. [Google Scholar] [CrossRef] [PubMed]
- Haeseler, G.; Foadi, N.; Ahrens, J.; Dengler, R.; Hecker, H.; Leuwer, M. Tramadol, fentanyl and sufentanil but not morphine block voltage-operated sodium channels. Pain 2006, 126, 234–244. [Google Scholar] [CrossRef] [PubMed]
- Portero, V.; Wilders, R.; Casini, S.; Charpentier, F.; Verkerk, A.O.; Remme, C.A. KV4.3 Expression Modulates NaV1.5 Sodium Current. Front. Physiol. 2018, 9, 178. [Google Scholar] [CrossRef] [PubMed]
- Golibkhon, A.; Ugli, B.A.G.; Ugli, M.M.F. Opioid Agents and Cardiac Arrhythmia: A Literature Review. Cureus 2023, 15, e38007. [Google Scholar] [CrossRef]
Variables | (n = 218) |
---|---|
Age, years | 46.20 ± 17.19 |
Gender female/male (%) | 120 (55)/98 (45) |
Body mass index (kg/m2) | 28.56 ± 6.53 |
Geographic information | Şanlıurfa/Türkiye |
Operation time (minute) | 60 (45–100) |
ASA score | 1.90 ± 0.80 |
Length of stay (day) | 2 (2–4) |
Tramadol dose (mg) | 98.21 ± 7.62 |
Glucose (mg/dl) | 116.02 ± 41.70 |
Urea (mg/dl) | 28 (21–36) |
Creatinine (mg/dl) | 0.77 ± 0.20 |
AST (U/L) | 24 (18–30) |
ALT (U/L) | 22 (16–29) |
Sodium (mmol/L) | 138.62 ± 3.16 |
Potassium (mmol/L) | 4.09 ± 0.45 |
Calcium (mg/dl) | 8.90 ± 0.93 |
CRP (mg/L) | 1 (0–3) |
WBC (×103/µL) | 7 (6–9) |
Hemoglobin (g/dL) | 12.86 ± 2.31 |
Hematocrit (%) | 39.92 ± 6.39 |
Parameters | Pre-Procedure | Post-Procedure | Δ (%) | p |
---|---|---|---|---|
Heart Rate (b/pmin) | 77.61 ± 15.40 | 77.91 ± 14.61 | 0.5 | 0.505 |
QT (ms) | 339.17 ± 36.27 | 349.88 ± 30.86 | 2.41 | 0.001 |
QTc (ms) | 407.07 ± 26.36 | 419.64 ± 31.78 | 2.41 | <0.001 |
QRS (ms) | 80.82 ± 11.39 | 78.57 ± 9.80 | −4.5 | 0.018 |
ICEB | 4.26 ± 0.69 | 4.52 ± 0.70 | 3.6 | <0.001 |
ICEBc | 5.14 ± 0.86 | 5.42 ± 0.79 | 3.3 | <0.001 |
Variables | B | SE | β | t | p |
---|---|---|---|---|---|
Age | 0.004 | 0.003 | 0.090 | 1.342 | 0.181 |
Body mass index | 0.009 | 0.008 | 0.073 | 1.086 | 0.279 |
Operation time | 0.001 | 0.001 | 0.030 | 0.417 | 0.667 |
Hemoglobin | 0.027 | 0.024 | 0.079 | 1.150 | 0.252 |
Potassium | 0.213 | 0.117 | 0.116 | 1.826 | 0.069 |
Sodium | 0.018 | 0.017 | 0.071 | 1.063 | 0.289 |
Tramadol dose | 0.021 | 0.007 | 0.201 | 3.036 | 0.003 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Yönder, H.; Toprak, K.; Berhuni, M.S.; Elkan, H.; Tatlı, F.; Özgönül, A.; Yüksekyayla, B.; Koyuncu, H.; Taşcanov, M.B.; Fedai, H.; et al. The Relationship Between Tramadol Use and Cardio Electrophysiological Balance for Postoperative Pain Treatment in General Surgery Patients. Medicina 2024, 60, 1731. https://doi.org/10.3390/medicina60111731
Yönder H, Toprak K, Berhuni MS, Elkan H, Tatlı F, Özgönül A, Yüksekyayla B, Koyuncu H, Taşcanov MB, Fedai H, et al. The Relationship Between Tramadol Use and Cardio Electrophysiological Balance for Postoperative Pain Treatment in General Surgery Patients. Medicina. 2024; 60(11):1731. https://doi.org/10.3390/medicina60111731
Chicago/Turabian StyleYönder, Hüseyin, Kenan Toprak, Mehmet Sait Berhuni, Hasan Elkan, Faik Tatlı, Abdullah Özgönül, Baran Yüksekyayla, Hamza Koyuncu, Mustafa Beğenç Taşcanov, Halil Fedai, and et al. 2024. "The Relationship Between Tramadol Use and Cardio Electrophysiological Balance for Postoperative Pain Treatment in General Surgery Patients" Medicina 60, no. 11: 1731. https://doi.org/10.3390/medicina60111731
APA StyleYönder, H., Toprak, K., Berhuni, M. S., Elkan, H., Tatlı, F., Özgönül, A., Yüksekyayla, B., Koyuncu, H., Taşcanov, M. B., Fedai, H., Ocak, M., Arğa, Y., & Uzunköy, A. (2024). The Relationship Between Tramadol Use and Cardio Electrophysiological Balance for Postoperative Pain Treatment in General Surgery Patients. Medicina, 60(11), 1731. https://doi.org/10.3390/medicina60111731