Browse > Article
http://dx.doi.org/10.17245/jdapm.2021.21.3.245

Effectiveness of tramadol compared to lignocaine as local anesthesia in the extraction of firm teeth: a randomized controlled trial  

Goel, Manu (Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital)
Sen, Pinaki (Consultant Oral Maxillofacial Surgeon, Zayed Military Hospital)
Maturkar, Tushar (Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital)
Latke, Siddhesh (Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital)
Dehankar, Tejasvini (Department of Oral and Maxillofacial Surgery, Swargiya Dadasaheb Kalmegh Smruti Dental College and Hospital)
Publication Information
Journal of Dental Anesthesia and Pain Medicine / v.21, no.3, 2021 , pp. 245-252 More about this Journal
Abstract
Background: The aim of this study was to compare the local anesthetic effect of tramadol with that of lignocaine in the extraction of immobile (grade 0) maxillary first molars. Methods: This was a randomized, double-blind, equally balanced, controlled trial conducted on a sample population of 116 patients. The patients were randomly divided into two groups: group A (control) and group B (study). Group A and group B participants received 1.8 ml of 2% lignocaine without adrenaline and 1.8 ml of 5% tramadol, respectively through the supra-periosteal infiltration technique before extraction. Intraoperative pain was recorded on the Visual Analog Scale (VAS) and was evaluated using two unpaired t-tests. Results: Intraoperative pain was evaluated in both the control and study groups. In the control group, the mean VAS score was 0.71 ± 0.81, while in the study group, the mean intraoperative VAS score was 1.21 ± 0.86, with the difference between the two mean values being statistically significant (P = 0.001). Conclusion: Tramadol has a less potent local anesthetic effect than lignocaine. As a higher dose of tramadol is required to obtain the desired anesthetic effect, it should be used as a supplement to lignocaine in extensive surgical procedures. It can also be used in patients allergic to lignocaine.
Keywords
Lidocaine; Local Anesthesia; Pain; Randomized Controlled Trials; Tramadol;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Sousa AM, Cutait MM, Ashmawi HA. Evaluation of the addition of tramadol on lidocaine-induced motor block regression time: experimental study in rats. Revista Dor 2013; 14: 129-32.   DOI
2 Acalovschi I, Cristea T, Margarit S, Gavrus R. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg 2001; 92: 209-14.   DOI
3 Pang WW, Mok MS, Chang DP, Huang MH. Local anesthetic effect of tramadol, metoclopramide, and lidocaine following intradermal injection. Reg Anesth Pain Med 1998; 23: 580-3.   DOI
4 Shrestha BR, Bista B. Tramadol along with local anaesthetics in the penile block for the children undergoing circumcision. Kathmandu Univ Med J (KUMJ) 2005; 3: 26-9.
5 Mert T, Gunes Y, Guven M, Gunay I, Ozcengiz D. Blocking action of tramadol on nerve conduction. Intern J Pharmacol 2001; 1.
6 Altunkaya H, Ozer Y, Kargi E, Ozkocak I, Hosnuter M, Demirel CB, Babuccu O. The postoperative analgesic effect of tramadol when used as subcutaneous local anesthetic. Anesth Analog 2004; 99: 1461-64.
7 Eliav E, Gracely RH. Measuring and assessing pain. Orofacial pain and headache. Philadelphia, PA, Elsevier Health Sciences. 2008
8 Staiman A, Seeman P. The impulse-blocking concentrations of anesthetics, alcohols, anticonvulsants, barbiturates, and narcotics on phrenic and sciatic nerves. Can J Physiol Pharmacol 1974; 52: 535-50.   DOI
9 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: 234-44.   DOI
10 Altunkaya H, Ozer Y, Kargi E, Babuccu O. Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures. Br J Anaesth 2003; 90: 320-2.   DOI
11 World Health Organization. Tramadol update review report. Available from http://www.who.int/medicines/areas/quality_safety/6_1_ Update.pdf
12 Guven M, Mert T, Gunay I. Effects of tramadol on nerve action potentials in rat: comparisons with benzocaine and lidocaine. Intern J Neurosci 2005; 115: 339-49.   DOI
13 Gissen AJ, Gugino LD, Datta S, Miller J, Covino BG. Effects of fentanyl and sufentanil on peripheral mammalian nerves. Anesth Analg 1987; 66: 1272-6.
14 Tsai YC, Chang PJ, Jou IM. Direct tramadol application on sciatic nerve inhibits spinal somatosensory evoked potentials in rats. Anesth Analg 2001; 92: 1547-51.   DOI
15 Mert T, Gunes Y, Guven M, Gunay I, Ozcengiz D. Comparison of nerve conduction blocks by an opioid and a local anaesthetic. Eur J Pharmacol 2002; 439: 77-81.   DOI
16 Al-Haideri YA. Comparison of local anesthetic efficacy of tramadol hydrochloride (with adrenaline) versus plain tramadol hydrochloride in the extraction of upper molar teeth. J Oral Maxillofac Surg 2013; 71: 2035-8.   DOI
17 Vickers MD, O'flaherty D, Szekely SM, Read M, Yoshizumi J. Tramadol: pain relief by an opioid without depression of respiration. Anaesthesia 1992; 47: 291-6.   DOI
18 Sacerdote P, Bianchi M, Manfredi B, Panerai AE. Effects of tramadol on immune responses and nociceptive thresholds in mice. Pain 1997; 72: 325-30.   DOI
19 Kargi E, Isikdemir A, Tokgoz H, Erol B, Isikdemir F, Hanci V, Payasli C. Comparison of local anesthetic effects of tramadol with prilocaine during circumcision procedure. Urology 2010; 75: 672-5.   DOI
20 Bennett CR. Monheim's local anesthesia and pain control in dental practice, 7th ed. Ontario, B.C.Decker. 1990.
21 Mert T, Gunes Y, Ozcengiz D, Gunay I, Polat S. Comparative effects of lidocaine and tramadol on injured peripheral nerves. Eur J Pharmacol 2006; 543: 54-62.   DOI
22 Jaffe RA, Rowe MA. A comparison of the local anesthetic effects of meperidine, fentanyl and sufentanil on dorsal root axons. Anesth Analg 1996; 83: 776-81.   DOI
23 Scott LJ, Perry CM. Tramadol: A review of its use in perioperative pain. Drugs 2000; 60: 139-76.   DOI
24 Vahabi S, Heidari M, Ahmedinejad M, Akhlagi J, Birjandi M. Comparison of local anesthetic effect of tramadol and lidocaine used subcutaneously in minor surgeries with local anesthesia. Middle East J Anesthesiol 2011; 21: 9-13.
25 Polat F, Tuncel A, Balci M, Aslan Y, Sacan O, Kisa C, et al. Comparison of local anesthetic effects of lidocaine versus tramadol and effect of child anxiety on pain level in circumcision procedure. J Pediatr Urol 2013; 9: 670-4.   DOI
26 Brau ME, Koch ED, Vogel W, Hempelmann G. Tonic blocking action of meperidine on Na+ and K+ channels in amphibian peripheral nerves. Anesthesiology 2000; 92: 147-55.   DOI
27 Malamed SF. Handbook of local anesthesia, 6th ed. St. Louis, Mosby. 2013.
28 Jendi SK, Syed AM, Badal S, Doiphode A, Chougule SS, Shaikh SA, et al. Comparison of local anaesthetic efficacy of tramadol versus lignocaine for extraction of tooth under supraperiosteal infiltration. J Maxillofac Oral Surg 2019; 18: 100-5.   DOI