JOURNAL HOME CME HOME THIS MONTH PAST ISSUES ETOC COLLECTIONS AUTHORS REVIEWERS EDITORIAL BOARD FEEDBACK RSS HELP
		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (39) Citing Articles via Google Scholar Google Scholar Articles by Arcioni, R. Articles by Gasparetto, A. Search for Related Content PubMed PubMed Citation Articles by Arcioni, R. Articles by Gasparetto, A. Related Collections Pain Pharmacology

---

TECHNOLOGY, COMPUTING, AND SIMULATION

Ondansetron Inhibits the Analgesic Effects of Tramadol: A Possible 5-HT₃ Spinal Receptor Involvement in Acute Pain in Humans

Roberto Arcioni, MD^*, Marco della Rocca, MD^*, Sarah Romanò, MD^*, Rocco Romano, MD, Paolo Pietropaoli, MD^*, and Alessandro Gasparetto, MD^*

Departments of Anesthesiology, *Institute of Anesthesiology and Intensive Care, Rome University "La Sapienza," Rome; and Institute of Anesthesiology and Intensive Care, Ancona University, Ancona, Italy

Address correspondence and reprint requests to Roberto Arcioni, MD, Via Monte Zeda, 9-00141 Roma, Italia. Address e-mail to r.arcioni{at}virgilio.it

To investigate a possible antinociceptive role of serotonin receptor subtype 3 (5-HT₃), we evaluated the effects of a coadministration of ondansetron, a 5-HT₃ selective antagonist, and tramadol, a central analgesic dependent on enhanced serotonergic transmission. Fifty-nine patients undergoing ear, throat, and nose surgery, using tramadol for 24-h postoperative patient-controlled analgesia (bolus = 30 mg; lockout interval = 10 min) were randomly allocated either to a group receiving ondansetron continuous infusion (1 mg · mL^-1 · h^-1) for postoperative nausea and vomiting (Group O) or to a control group receiving saline (Group T). Pain and vomiting scores and tramadol consumption were evaluated at 4, 8, 12, and 24 h. Pain scores were never >4, according to a 0–10 numerical rating scale, in both groups. Group O required significantly larger doses of tramadol at 4 h (213 versus 71 mg, P < 0.001), 8 h (285 versus 128 mg, P < 0.002), and 12 h (406 versus 190 mg, P < 0.002). Vomiting scores were higher in Group O at 4 h (P < 0.05) and 8 h (P = 0.05). We conclude that ondansetron reduced the overall analgesic effect of tramadol, probably blocking spinal 5-HT₃ receptors.

IMPLICATIONS: Serotonin is an important neurotransmitter of the descending pathways that down-modulate spinal nociception. In postoperative pain, ondansetron, a selective 5-HT₃ receptor antagonist, increased the analgesic dose of tramadol. We suggest that, when antagonized for antiemetic purpose, 5-HT₃ receptors foster nociception, because of their site-dependent action.

This article has been cited by other articles:

				A. Zeidan, R. Kassem, N. Nahleh, H. Maaliki, M. El-khatib, M. M.R.F. Struys, and A. Baraka Intraarticular Tramadol-Bupivacaine Combination Prolongs the Duration of Postoperative Analgesia After Outpatient Arthroscopic Knee Surgery Anesth. Analg., July 1, 2008; 107(1): 292 - 299. [Abstract] [Full Text] [PDF]

				C. Dursteler, A. Mases, and M. M. Puig Universal PONV Prophylaxis in General Anesthesia: Should We Consider Its Immediate Implementation? Anesth. Analg., June 1, 2008; 106(6): 1922 - 1922. [Full Text] [PDF]

				P. F. White and P. S. A. Glass Universal PONV Prophylaxis in General Anesthesia: Should We Consider Its Immediate Implementation? Anesth. Analg., June 1, 2008; 106(6): 1922 - 1923. [Full Text] [PDF]

				H. A. Mowafi, S. A. Arab, S. A. Ismail, and A. Al-Ghamdi The Effects of Intravenous Granisetron on the Sensory and Motor Blockade Produced by Intrathecal Bupivacaine Anesth. Analg., April 1, 2008; 106(4): 1322 - 1325. [Abstract] [Full Text] [PDF]

				A. Georgy, J. Neceskas, and S. Goodin Antiemetic care for patients with breast cancer: Focus on drug interactions and safety concerns Am. J. Health Syst. Pharm., November 1, 2007; 64(21): 2227 - 2236. [Abstract] [Full Text] [PDF]

				C. A. Iatrou, C. K. Dragoumanis, T. D. Vogiatzaki, G. I. Vretzakis, C. E. Simopoulos, and V. K. Dimitriou Prophylactic Intravenous Ondansetron and Dolasetron in Intrathecal Morphine-Induced Pruritus: A Randomized, Double-Blinded, Placebo-Controlled Study Anesth. Analg., November 1, 2005; 101(5): 1516 - 1520. [Abstract] [Full Text] [PDF]

				A. Fassoulaki, A. Melemeni, M. Zotou, and C. Sarantopoulos Systemic Ondansetron Antagonizes the Sensory Block Produced by Intrathecal Lidocaine Anesth. Analg., June 1, 2005; 100(6): 1817 - 1821. [Abstract] [Full Text] [PDF]

				S. Mannion, S. O'Callaghan, D. B. Murphy, and G. D. Shorten Tramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study Br. J. Anaesth., March 1, 2005; 94(3): 352 - 356. [Abstract] [Full Text] [PDF]

				S. Robaux, C. Blunt, E. Viel, P. Cuvillon, P. Nouguier, G. Dautel, S. Boileau, F. Girard, and H. Bouaziz Tramadol Added to 1.5% Mepivacaine for Axillary Brachial Plexus Block Improves Postoperative Analgesia Dose-Dependently Anesth. Analg., April 1, 2004; 98(4): 1172 - 1177. [Abstract] [Full Text] [PDF]

Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999