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Effect of tramadol as an adjuvant to local anesthetics for brachial plexus block: A systematic review and meta-analysis

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  • Hye Won Shin
  • Bum Jun Ju
  • Yoo Kyung Jang
  • Hae Seun You
  • Hyun Kang
  • Ji Yong Park

Abstract

Background: Tramadol, a 4-phenyl-piperidine analog of codeine, has a unique action in that it has a central opioidergic, noradrenergic, serotonergic analgesic, and peripheral local anesthetic (LA) effect. Many studies have reported contradictory findings regarding the peripheral analgesic effect of tramadol as an adjuvant to LA in brachial plexus block (BPB). This meta-analysis aimed to evaluate the effects of tramadol as an adjunct to LA in BPB during shoulder or upper extremity surgery. Methods: We searched the PubMed, EMBASE, Cochrane, KoreaMed databases, and Google Scholar for eligible randomized controlled trials (RCTs) that compared BPB with LA alone and BPB with LA and tramadol. Primary outcomes were the effects of tramadol as an adjuvant on duration of sensory block, motor block, and analgesia. Secondary outcomes were the effects of tramadol as an adjuvant on time to onset of sensory block and motor block and on adverse effects. We performed the meta-analysis using Review Manager 5.3 software. Results: We identified 16 RCTs with 751 patients. BPB with tramadol prolonged the duration of sensory block (mean difference [MD], -61.5 min; 95% CI, -95.5 to -27.6; P = 0.0004), motor block (MD, -65.6 min; 95% CI, -101.5 to -29.7; P = 0.0003), and analgesia (MD, -125.5 min; 95% CI, -175.8 to -75.3; P

Suggested Citation

  • Hye Won Shin & Bum Jun Ju & Yoo Kyung Jang & Hae Seun You & Hyun Kang & Ji Yong Park, 2017. "Effect of tramadol as an adjuvant to local anesthetics for brachial plexus block: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-19, September.
    • Handle: RePEc:plo:pone00:0184649
    DOI: 10.1371/journal.pone.0184649
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    1. Unknown, 2004. "Table of Contents," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 7(4), pages 1-1.
    2. Meghan A Kirksey & Stephen C Haskins & Jennifer Cheng & Spencer S Liu, 2015. "Local Anesthetic Peripheral Nerve Block Adjuvants for Prolongation of Analgesia: A Systematic Qualitative Review," PLOS ONE, Public Library of Science, vol. 10(9), pages 1-23, September.
    3. Unknown, 2004. "Table of Contents," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 7(2), pages 1-1.
    4. Unknown, 2004. "Table of Contents," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 7(3), pages 1-1.
    5. Unknown, 2004. "Table of Contents," International Food and Agribusiness Management Review, International Food and Agribusiness Management Association, vol. 7(1), pages 1-1.
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