Mehmet BEYAZOVA, Ertan ÖZTÜRK, MURAT ZİNNUROĞLU, İsmail GÖKYAR, Avni BABACAN, Kadir KAYA

Effects of perineural tramadol on nerve conduction of sural nerve

Amaç: Çalışmanın amacı sağlıklı gönüllülerde sural sinire perinöral olarak uygulanan tramadolün sinir iletimi üzerine doz bağımlı bloke edici etkinliğinin olup olmadığının araştırılmasıdır. Gereç ve Yöntem: 24 bilgilendirilmiş sağlıklı denek eşit olarak 4 gruba [Salin (plasebo), % 0.5 tramadol, %1 tramadol and %1.5 tramadol] ayrıldı. Çalışma çift kör olarak tasarlandı. Duyusal sinir aksiyon potansiyelleri elektronörografik olarak kaydedildi. 2 ml’lik çalışma solüsyonu sinir stimülatörü yardımı ile ayak bileği düzeyinde sural sinire perinöral olarak enjekte edildi. İzleyen kayıtlamalarda duyu yanıtı amplitüdünün bazal değerin % 80’inin altına inmesi durumunda duyusal blok oluştuğu kabul edildi. Bulgular: Elektronörografik kayıtlara göre salin grubundaki hiçbir denekte blok gelişmedi. Bununla birlikte, % 0.5, % 1 ve % 1.5 tramadol ile blok gelişim oranları sırasıyla 1/6, 4/6 ve 6/6’ydı. Başlangıç düzeylerine göre duysal aksiyon potansiyeli amplitüdlerinin ortanca değerlerindeki maksimum azalma salin grubunda %7.8, %0.5 tramadol ile %12.5, %1 tramadol ile %38.5 ve %1.5 tramadol ile %77.5’di (p

Perinöral tramadolün sural sinir iletimi üzerine etkisi

Objectives: The aim of this study was to investigate whether tramadol had a dose dependent blocking effect on nerve conduction when administered perineurally to the sural nerve of healthy volunteers. Methods: 24 informed healthy subjects were randomized into four equal groups [Saline (placebo), 0.5% tramadol, 1% tramadol and 1.5% tramadol]. The study was designed to be double-blinded. Sensory nerve action potentials were recorded electroneurographically. Two mililiters of study solution was administered to sural nerve perineurally at the level of ankle by the guidance of a nerve stimulator. A sensory block was assumed to have developed when the amplitude of the averaged sensory nerve action potentials diminished below 80% of the baseline value in the subsequent recordings. Results: According to electroneurographical recordings, none of the volunteers in saline group had block. However, the block rates with 0.5%, 1% and 1.5% tramadol were 1/6, 4/6 and 6/6 respectively (p<0.05). The maximum decrement in the sensory action potential amplitudes with respect to baseline amplitudes given as median values were as follows: 7.8% with saline; 12.5% with 0.5% tramadol; 38.5% with 1% tramadol and 77.5% with 1.5% tramadol (p<0.05). While the median duration of sensory block with 0.5% tramadol was 5 minutes, it was 15 minutes with 1% tramadol and 35 minutes with 1.5% tramadol. Conclusion: Perineurally administered tramadol blocks sensory nerve conduction of sural nerve in a dose dependent manner.

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