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Article
The Effectiveness of Tramadol in Treatment of Premature Ejaculation on-Demand Basis

Authors: Montadhar H. Nima --- Samir Ali Muter --- Ahmed Samir Al-Naaimi --- Nibbras I. Al-Hamdani
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 3 Pages: 429-435
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT: *Department of Surgery, College of Medicine, University of Baghdad.**Department of Surgery, College of Medicine, University of Baghdad.***Department of Community Medicine, College of Medicine, University of Baghdad.****Consultant Urologist, Baghdad Medical City. BACKGROUND: Premature ejaculation (PE) is a worldwide problem. Selective serotonin reuptake inhibitors (SSRIs) arewidely used “off label” as pharmacotherapeutic agents in the treatment of PE. OBJECTIVE: Assess the efficacy of Tramadol for on-demand treatment of PE. PATIENTS AND METHODS: During the period December 2008 through November 2009, 60 married men visited the surgicalspecialties hospital urology outpatient and consultancy clinics complaining of premature ejaculationwere enrolled in this study. Intravaginal ejaculation latency time (IVELT) was used as an objective toolto assess the efficacy of the investigated treatment. Single-blind, placebo-controlled therapeutic trialwas conducted on 60 patients with lifelong PE. PE was defined as IVELT of <2 minutes in at least 80%of intercourse episodes. The patients cohort was randomised into 2 equal sized groups. The interventiongroup (n=30) used 50 mg tablet of Tramadol hydrochloride, while the control group (n=30) used aplacebo tablet for 8 weeks. Drugs were taken 1–2 hours before sexual activity, and sexual intercoursewas required at least once per week. IVELT was timed by a stopwatch at each intercourse. RESULTS: The mean IVELT after tramadol and placebo significantly increased from 73.1 and 67.9 seconds toapproximately 442.1 and 113.3 seconds, respectively (P < 0.001). Sexual satisfaction was used to assessthe cut-off values of IVELT in defining the minimal and best clinical response to treatment. There wasno withdrawal symptoms recorded following the use of tramadol or placebo, but more adverse eventswere associated with tramadol treatment CONCLUSION: Tramadol seems to provide significantly better results in terms of IVELT and intercourse satisfactionversus placebo. Further studies are required to draw final conclusions on the efficacy of this drug inpremature ejaculation

Keywords

premature --- ejaculation --- tramadol


Article
EXPLORE THE SYNERGISM OF SEDATIVE DOSE MEDETOMIDINE WITH TRAMADOL TO INDUCE ANALGESIC EFFECTS IN RABBITS
تاثيرات الجرعه تحت المسكنه ( المسدره) للميديتوميدين والترامدول معا لاحداث التسكين في الارانب

Author: Mahmood. B. Mahmood
Journal: Basrah Journal of Veterinary Research. مجلة البصرة للابحاث البيطرية ISSN: Print:18138497 E; 24108456 Year: 2016 Volume: 15 Issue: 2 Pages: 97-110
Publisher: Basrah University جامعة البصرة

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Abstract

The study was designed to evaluate the analgesic effects of Medetomidine and Tramadol in rabbits, to detect the best dose (as onset and duration) for antinociceptive in this model, also evaluate the antinociceptive effect as sedative doses in these drugs as a mixture by using electrical stimulator. Administration of Medetomidine alone at 200 µgkg B.W. (I.M) and Tramadol alone at 2 mg kg B.W. (I.P) were the best doses for relief pain induced by electrical stimuli. There was increased in the voltage change for pain ( 15, 30, 45, 60, 75, 90 minutes) in comparison with control and other doses for each drug. Administration of Medetomidine at 50 µg kg B.W. (I.M) with Tramadol at 0.5 mg kg B.W. I.P) significantly referred to synergism of the antinociceptive effect which induced analgesia in 100 % of the rabbits in comparison with other groups for each drug alone (at the same analgesic doses) without any overt side effects and without differences in glucose, glutathione, ALT and AST level in animals. The data of this study demonstrated the mixture of Medetomidine and Tramadol at low doses (subanalgesic doses) had a typical synergistic effect (super-additive) for inducing good and safe analgesia as well as its skeletal muscle relaxation in rabbits.


Article
Efficacy of tramadol as analgesic and mixed with ketamine, xylazine as anesthetic in rabbits
كفاءة الترامادول كمسكن للألم وبعد خلطة مع الكيتاين والزايلازين كمخدر في الأرانب

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Abstract: This study were performed to evaluate the efficacy of Tramadol as analgesic and efficacy of using Tramadol in combination with other drugs like Ketamine and Xylazine in anesthetic protocols in rabbits. 15 adult New Zealand white rabbits divided to 3 equal groups were anesthetized intramuscularly in one syringe, group 1 with Tramadol 15 mg/kg B.W, group 2 with Tramadol 15mg/Kg B.W and Ketamine 30mg/Kg B.W, group 3 with Tramadol 15mg/Kg B.W and Ketamine 30mg/Kg B.W and Xylazine 5mg/Kg B.W, physiologic parameters were evaluated including : body temperature, heart rate, respiratory rate, muscle relaxation, analgesia and stages of anesthesia ( Induction of anesthesia, surgical anesthesia and recovery time).The most significant changes were reported in G3 (T15K30X5) and this combination is useful regimen clinically for anesthetize rabbits due to the fast of induction anesthesia and the long surgical duration of anesthesia.

الخلاصة: تمت هذه الدراسة لغرض تقييم كفاءة الترامدول كمسكن وكفاءة استخدام الترامدول مع ادوية اخرى مثل الكيتامين والزايلازين كبرامج تخدير في الأرانب. 15 ارنب ناضج سلالة محلية قسمت الى 3 مجاميع متساوية تم تخديرها بالحقن في العضلة في محقنة واحدة, المجموعة الأولى ترامدول 15ملغم/كغم من وزن الجسم, المجموعة الثانية ترامدول 15ملغم/كغم , كيتامين 30ملغم/كغم من وزن الجسم ,المجموعة الثالثة ترامدول 15ملغم/كغم, كيتامين 30ملغم/كغم و زايلازين 5ملغم/كغم من وزن الجسم. تم تقييم المعايير الفسلجية المتضمنة : درجة حرارة الجسم, معدل ضربات القلب, معدل التنفس, درجة الأرتخاء العضلي, درجة التسكين وايظاً تم تسجيل ( وقت احداث التخدير, طول فترة التخدير الجراحي, وقت الأفاقة). معظم التغيرات المعنوية سجلت في المجموعة الثالثة (ترامدول15كيتامين30زايلازين5) ملغم/كغم وهذا المزيج يعتبر نظام مفيد سريرياً لتخدير الأرانب وذلك لسرعة احداث التخدير وطول فترة التخدير الجراحي.


Article
A comparison Between the Transversus Abdominis Plane (TAP) Block Versus Traditional Parentral Analgesia Post Caesarian Section

Authors: Iyad Abbas Salman --- Hayder Saad Kamel
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: supplement Pages: 718-723
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Postoperative pain, especially when poorly controlled, results in harmful acute effects (i.e., adverse physiologic responses) and chronic effects (i.e., delayed long-term recovery and chronic pain).The transversus abdominis plane (TAP) block is a new method of providing postoperative analgesia in patients undergoing lower abdominal wall incisionsOBJECTIVE:To compare the effectiveness of TAP block versus traditional parenteral analgesia post caesarian section.PATIENTS AND METHODS:A prospective randomized double blinded placebo controlled clinical trial conducted in the department of obstetrics & gynecology of medical city complex. over a period of four months from 1st of November to 1st of march. Fifty women patients were selected to be enrolled in this study who were scheduled for C.S. via pfannenstiel incision, all patients were of ASA I- II physical status. Twenty five of them were given TAP block with (bupivacaine 0.25%) & placebo i.v saline (0.9%) , the other twenty five were given i.v tramadol & i.m diclofinac sodium & placebo TAP block with normal saline 0.9%.Numerical rating scale was used to follow up the patients postoperatively at 2,6,12,16 hours.RESULTS :By comparing the means of numerical analogue scale score over the time there was a significant difference in mean score over the time, the traditional treatment had better effect on relieving pain only at the 1st 2 hours where TAP block was better on the rest time with a highly significant difference P.value < 0.05 in all comparisons.CONCLUSION:TAP block is not effective as sole analgesic, but is effective in reducing the frequency of doses of incremental analgesia. TAP block is more effective than traditional analgesia in reducing the mean of pain score .The traditional parentral analgesia require more frequent dosing.


Article
Effect of Tramadol on Ovine Ureteral Smooth Muscle Contractility: an in vitro Experimental Study
تأثير مادة الترامادول على حركة العضلات الملساء للحالب الضأني المعزول: دراسة مختبرية

Authors: Atheer K. Zgair اثير خلف زغير --- Majid A. K. Lafi مجيد عبدالكريم لافي --- Jamal A. Noman جمال عبد الرحمن نعمان
Journal: Al- Anbar Medical Journal مجلة الأنبار الطبية ISSN: PISSN: 27066207 / EISSN: 26643154 Year: 2013 Volume: 11 Issue: 1 Pages: 11-16
Publisher: University of Anbar جامعة الانبار

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Background: Tramadol was recently suggested to be an effective and relatively safe pharmacological treatment for pain and hyperalgesia in urinary colic from calculosis. It can apparently represent a valid therapeutic approach to this medical problem, especially in cases where conventional therapy cannot be applied. However, up to our knowledge, the in vitro effect of tramadol on ureteral smooth muscle contractility has not been investigated.Objectives: The aim of this study is to investigate the effect of tramadol on the ovine spontaneous ureteral activity and attempt to determine its pharmacological basis.Methods: In vitro experiments were performed on ureteral ring preparations in an organ bath. Contractions per minute (frequency) were calculated. The effect of tramadol, was obtained on its own and in the presence of naloxone, chlorpheniramine, phenoxybenzamine, atropine, or diclofenac; while, the effects of histamine, phenylephrine and acetylcholine (ACh) were recorded on their own and in the presence of their respective antagonists.Results: Tramadol (50M) significantly enhanced the spontaneous rhythmic motility (1.21 ± 0.25 to 3.3 ± 0.54). Further, naloxone (2M), chlorpheniramine (M), atropine (M), or diclofenac (10M) failed to inhibit the excitatory effect of tramadol. However, phenoxybenzamine (1M) appreciably attenuated the excitatory effect of tramadol.Conclusions: Tramadol produces substantial excitatory-ureteral activity by a mechanism that is still to be clarified and apparently not dependent on activation of opioid receptors, H1-receptors, muscarinic-receptors, or prostanoid synthesis and partly dependent on aminergic mechanisms

الخلفية: مادة الترامادول اقترحت مؤخرا لتكون جزءا فعالا والى حد ما امين من الادوية المستخدمة في علاج الام الكلى المصاحبة لوجود الحصى في الحالب. ان هذا المقترح قد يمثل نهج علاجي فعال لعلاج مثل هذه المشاكل الطبية وخاصة في الحالات التي لا يمكن فيها استخدام العلاجات التقليدية بسبب مضاعفاتها او الاعراض الجانبية الناتجة عن استخدامها. بيد انه, وحسب علمنا فان تأثير مادة الترامادول على العضلات الملساء للحالب المعزول لم يتم اختباره من قبل.الاهداف: إن الهدف من هذه الدراسة هو معرفة تأثير الترامادول على تردد القطع المفصولة من العضلة الملساء للحالب الضأني والمتقلصة تلقائيا, ومعرفة الاسس الدوائية لعمل هذه المادة.طرائق العمل: أُجريَت التجارب على عَضلةٍ مِن الحلقات الحالبية في حَمامٍ عضْوي، شوهد إن العضلة تَعْرض تقلصات مرحلية منسَقة. تم إحتساب التردد للإنقباضات للدقيقة الواحدة. اختبر تاثير الترامادول لوحده على الحالب ومن ثم بوجود كل من النالوكسون او الكلورْفينرْأمين او الفينوكسيبنزْأمين او الأتروبين او الدايكلوفِيناك كل على حدة. تم تسجيل تاثير كل من الهِيستامين والفينايلْفرين والأستيلْكولين كل على حدة وايضا بوجود مضاد المستقبلات الخاص بهم. النتائج: لوحظ ان الترامادول (50 مايكرومول) تسبب في زيادة حركة النسقْ التلقائية للحالب (من 1,21 ± 0,25 إلى 3,3 ± 0,54). رُغمَ أن النالوكسون (2 مايكرومول) أو الكلورْفينرْأمينْ (1 مايكرومول) أو الأتروبين (1 مايكرومول) أو الدايكلوفِيناك (10 مايكرومول) فَشِلوا في تثبيط زيادة حركة النسق التلقائية للحالب العائدة لتاثير الترامادول. بيد ان الفينوكسيبينزْأمين (1 مايكرومول) خفف بشكل ملحوظ فعالية الترامادول.الاستنتاجات:. الترمادول ادى إلى زيادة ملحوظة في حركة النَسقْ التِلقائية للحالب الضأني والتي لازالت تحتاج إلى توضيح. كما أن هذا التأثير على ما يبدو لايعتمد على تحفيز كل مِن مستَقبلاتْ المُؤفينَة أو المستَقبلاتْ المَسكارِينيَة أو حتى على عملية إنتاجْ البروستانويد ويبدو بانها تعتمد بشكل جزئي على الألية الامينية.


Article
Anti–Nociceptive Efficacy of Tramadol Following Surgical Removal of Impacted Mandibular Third Molar

Author: Tahani A Al-Sandook
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2013 Volume: 13 Issue: 1 Pages: 88-94
Publisher: Mosul University جامعة الموصل

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Aims of the Study: To evaluate the efficacy of analgesia mediated by preoperative 100 mg IM Tra-madol to the post operative Tramadol and placebo after the surgical removal of mandibular wisdom tooth. Materials and Methods: Surgical removal of mandibular third molar was performed in three groups of individuals, total of thirty patients were anticipated in this study. All medically fit, average of age 24 + 2.2; each group consisted of ten patients. Group 1: Preoperative 100 mg Tramadol IM injec-tion 30 minutes prior surgical operation; Group 2: Post operative 100 mg Tramadol IM injection; Group 3: Placebo or control group where distilled water IM injection was applied. All patients received post operatively Augmentin capsules 675 mg tid, and supplementary Paracetamol 500 mg tablet as required. Analgesia was assessed by Visual Analog Scale (VAS) and Verbal Pain Scale (VPS), patient satisfaction (PS), duration of post operative analgesia and total number of analgesic tablet were record-ed between groups. Results: Analgesia mediated by Tramadol was superior in its efficacy compared to control group in both pre and post operative Tramadol groups, according to VAS and VPS assessment (p= 0.001). There was no significant difference between the preoperative and post operative analgesia according to VAS and VPS; whereas there was a significant difference in PS, and duration of analgesia mediated by the preoperative injection in comparison to the post operative and control groups. Conclu-sion: Preoperative Tramadol analgesia was superior to post operative analgesia in PS and prolonged duration of analgesia that explain its anti–nociceptive effect in controlling post surgical pain.


Article
Efficacy of Combined Tramadol with Diclofenac in Comparison with Monotherapy Treatment Using Buscopan Diclofenac or Tramadol in Renal Pain Control

Authors: Hussein Oudah Al-Jasmawy --- Adel Ibraheem Muhi --- Ali Abdulhaleem Kadhim
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 4 Pages: 1070 -1076
Publisher: Babylon University جامعة بابل

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Acute renal colic is a severe painful event; drugs used to treat this condition include anticholinergics, opioid analgesics and nonsteroidal anti-inflammatory drugs.To compare drug's efficacy in ureteric pain relief byusing monotherapy including Buscopan 20 mg IV, Diclofenac Sodium 75 mg IM and Tramadol 50 mg IV, with a combination of 2 drugs including Tramadol plus Diclofenac.160 patients (110 males and 50 females), 16 to 75 years of age, with moderate to severe renal pain were treated in emergency department of Hilla Teaching General Hospital and private clinics. Parameters were observed after 10, 30, 60, minutes and 2 hours of drugs treatment. Assessment of analgesic effect of the drugs was done by using Numerical Rating Scale (NRS). Drug side effects also observed.Buscopan was the least effective drug in pain relief with higher side effects, while Diclofenac and Tramadol have comparable efficacy. Combination of Diclofenac plus Tramadol had a significant efficacy with rapid and sustained pain relief.Incidence of ureteric colic are more common in males than females (male to female ratio is 3/1).For quick pain relief in acute renal colic, a combination of intravenous tramadol with diclofenac sodium is superior to each of them alone, while Buscopan is the least effective, with higher side effects.


Article
Determination of Paracetamol and Tramadol Hydrochloride in Pharmaceutical Preparations Using Green UV Method
تقدير الباراسيتامول وهيدروكلوريد الترامادول في مستحضراتهما الصيدلانية بطريقة خضراء طيفية

Authors: Hana Sh. Mahmood هناء شكر محمود --- Nagham T. Dawood نغم طه داؤد
Journal: Rafidain journal of science مجلة علوم الرافدين ISSN: 16089391 Year: 2018 Volume: 27 Issue: 1E Pages: 36-42
Publisher: Mosul University جامعة الموصل

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A simple, precise, and friendly environmental method for the determination of paracetamol and tramadol hydrochloride in pharmaceutical preparations has been worked out. The method is based on the determination of paracetamol at 242 nm and replaces its concentration in a multicomponent system equation for determination of both paracetamol and tramadol at 227 nm. Beer's law for paracetamol was obeyed over the concentration range 8-25 ppm at 242 nm and 4-16 ppm at 227 nm ,for tramadol it is obeyed over the range 2-14 ppm at 227 nm, water is used as a solvent for dissolution. The method is applicable to the determination of paracetamol and tramadol in their pharmaceutical preparations without prior separation steps from excipients as well as for determination of paracetamol in the presence of tramadol. The average recoveries for determination of mentioned drugs were 94.20-100.14%, and the average relative standard deviation of the method was better than ± 0.646%.

تم تقدير الباراسيتامول وهيدروكلوريد الترامادول في مستحضراتهما الصيدلانية بطريقة طيفية باستخدام طريقة مأمونة وسهلة وذات مضبوطية عالية. تعتمد الطريقة على إذابة المستحضر في الماء وتقدير الباراسيتامول عند طول موجي 242 نانوميتر ثم ايجاد تركيز الترامادول عند طول موجي 227 نانوميتر باستخدام معادلة الامتصاص لنموذج متعدد المكونات. اظهر الباراسيتامول خضوعا لقانون بيير لمدى من التراكيز25-8 جزء/ مليون عند الطول الموجي 242 نانوميتر ولمدى 16- 4 جزء / مليون عند الطول الموجي227 نانوميتر في حين اظهر الترامادول خضوعاً لقانون بيير لمدى من التراكيز 14-2 جزء / مليون عند الطول الموجي 227 نانوميتر. اظهرت الطريقة قابلية تطبيق للادوية المذكورة في مستحضراتهما الصيدلانيـة وكذلك تقديـر الباراسـيتامول بوجود الترامادول. كان معدل نسبة الاسترجاع لتقدير الأدوية المذكورة %100.14 -94.20 وكان معدل الانحراف القياسي النسبي للطريقة أفضل من ± 0.646%.


Article
Ultra violet spectrophotometric analysis of Paracetamol, Diclofenac and Tramadol drugs in mixture
تحليل ادوية الباراسيتامول, الدايكلوفينيك والترامادول في خليطهما باستخدام طيف الاشعة فوق البنفسجية

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The aim of this research was develop and validate an analytical method by Uv spectrophotometric technique for quantitative determination of paracetamol (PAR), diclofenac or voltarine (DIC) and tramadol or tramal (TRA) in tablet dosage form, paracetamol analysis is based on the absorbance maxima were found to be at 243 nm when dissolved in 0.1N H2SO4 as a sample and in 0.1N NaOH solution as a blank,. Quantitative of PAR in sample is achieved by standard addition methods and three ways calculations were used to estimate the amount in the tablet, the expected content per tablet were equal to (365.60, 361.984, 358.415 mg) and the results were acceptable when compared with original quantity in tablet(350 mg). The method was compared with standard curved method, showed that it is obeyed Beer – lambert law in the concentration range of 0.1–1 µg/ml for standard addition and standard curve methods, with a correlation coefficient of 0.9980 and o.9944. The limit of detection (LOD) for PAR was 0.036 µg/ml while limit of quantitation (LOQ) 0.119 µg/ml, the recovery of three procedure A, B, C of standard addition and standard curve were (104.40, 103.42, 102.40 and 92.995 %) for PAR ,it was found that the results obtained from the standard addition method were better than the result obtained from the standard curve method.The amount of (DIC) and (TRA) drug in tablet sample calculated depending on the absorbance (A) at 273 nm to give the value 47.44 mg and 47.6 mg per tablet are acceptable when compared with the value of the original quantity in tablet (50mg) and the recovery of the method was found to be (95.2 and 96.0 % ) respectively, the principle of the method based on the (A) of mixture at this λ is a total A of the two drugs, which owns different intensity at this λ at different percentages and that apply to the sample and standard for this drugs. Finally this can applied successfully for routine analysis.

هدف هذا البحث الى تطوير طريقة بسيطة وذات حساسية تعتمد على طيف الاشعة فوق البنفسجية لتقدير الباراسيتامول, الداي كلوفنك (فولتارين) والترامادول (ترامال) في المستحظرات الصيدلانية. تقدير الباراسيتامول يعتمد على قيمة المتصاصية عند الطول الموجي nm 243 عند اذابته قي محلول حامض الكبريتيك كنموذج مجهول وثم اذابته في محلول هيدروكسيد الصوديوم كبلانك, قدرت كمية الباراسيتامول في النموذج الدوائي بتطبيق طريقة الإضافة القياسية وباستحدام ثلاثة طرق حسابية وكانت النتائج (365.60, 361.984, 358.415 mg) في القرص الدوائي الواحد والتي أظهرت مقبولية عند مقارنتها مع طريقة المنحني القياسي, تبين من خلال النتائج ان الطريقتان تتوافق مع قانون بير– لامبرت بمدى من التراكيز 0.1–1 µg/ml) (، وكانت قيم معامل الارتباط 0.9980 ,o.9944 وحدود الكشف والكم µg/ml 0.036 و0.119 ), وقيم الاستردادية الناتجة من تطبيق الطرق الحسابية الثلاثة كانت % 104, 103, 102, تمت مقارنة النتائج مع النتائج المستحصلة من تطبيق طريقة المعايرة القياسية (325.483 ملغم) واظهرت النتائج ان طريقة الإضافة القياسية بحساباتها الثلاثة اكثر ملائمة لتقدير الباراسيتامول عند وجوده في خليط من الادوية. تم تقدير كمية عقاري الدايكلوفنك والترامادول في نفس الخليط واعتمادا على ان هذه الادوية تظهر امتصاصية بنسب وشدة مختلفة عند نفس الطول الموجي 273nm)) لتعطي قيم كيمة لهذه الادوية) 47.60 ,47.44 (ملغم والتي كانت مقبولة مقارنتا بكميتهما الفعلية في النموذج الدوائي(50 ملغم), إضافة الى ذلك فان قيم الاستردادية كانت تساوي 96.0, 95.2% على التوالي لكل منهما.ان المبدأ الأساسي لهذه الطريقة يتضمن ان الامتصاصية لخليط هذين الدوائين هو عبارة عن مجموع امتصاصيتهما عند نفس الطول الموجي وبنسب مختلفة والتي تطبق على النموذج المجهول والقياسي. واخيرا يمكن تطبيق هذه الطرق بنجاح في العمل الروتيني لتحليل تلك المواد .


Article
Evaluation Effect of Tramadol as Premedication on Ketamine in Mice

Authors: Ghada A Taqa --- Omar M Shallal
Journal: Al-Rafidain Dental Journal مجلة الرافدين لطب الأسنان ISSN: 18121217 Year: 2013 Volume: 13 Issue: 3 Pages: 555-559
Publisher: Mosul University جامعة الموصل

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Abstract

The present study was designed to investigate the effect of different doses of tramadol as a premedication on ketamine anesthesia in mice. Materials and Methods: Tramadol used in different doses ( 0, 20, 30 ) mg/kg, I.P at 20 minute before treated with ketamine (50) mg/kg, I.P. Results: significantly increased in the duration of sleep and analgesia of ketamine without effect on the time of induction in all treated groups. The Numerical Sedation Score(NSS) was increased in all treated groups with tramadol pre treatment of ketamine but this NSS were stayed in long period in group treated with tramadol and ketamine in a dose depended manner in comparison with group treated with ketamine alone. Conclusion: Thus it can conclude that the possibility of using tramadol as a premedication with ketamine general anesthesia to improve anesthesia

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