Effect of addition of tramadol to one MAC sevoflurane on the haemodynamic response to laryngoscopy and tracheal intubation

Objective: To evaluate the effect of tramadol 2 mg/kg on haemodynamic response to tracheal intubation where the end tidal concentration of sevoflurane was kept constant at 1 MAC (2%). study Design: Double blind randomized controlled trial. Place and Duration of study: The Aga Khan University Hospital, Karachi, from January 2009 to April 2009. Methodology: Thirty-four patients scheduled for surgery under general anaesthesia were randomly allocated to two groups, sevoflurane alone (2%) or sevoflurane (2%) and tramadol (2 mg/kg) combination. Anaesthesia was induced with thiopentone and atracurium and with either tramadol or placebo according to group allocation. Sevoflurane was administrated along with N2O and oxygen through the face mask till end tidal minimum alveolar concentration (MAC) of one (2%) was achieved. Haemodynamic changes were noted at 1, 2 and 3 minutes post induction and every minute upto 7 minutes post-intubation and compared with baseline values. results: A significant difference in heart rate was seen at 2 and 3 minutes post-induction and 1, 2 and 3 minutes postintubation between two groups with values higher in sevoflurane alone group. No significant difference was seen in systolic, diastolic, and mean blood pressure compared to baseline between the two groups. conclusion: HR and SBP values following laryngoscopy and tracheal intubation in both groups were less than 20% of baseline. Addition of tramadol 2 mg/kg to 1 MAC sevoflurane displayed further depression of chronotropic response to laryngoscopy and intubation as compared to sevoflurane alone following thiopentone and atracurium induction.