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Attenuation of C-Reactive Protein Increases After Exodontia by Tramadol and Ibuprofen
Eman A. El-Sharrawy MBBCh, MSc, MD,
 Ibrahim E. El-Hakim BDS, MDS, PhD, and
 Elham Sameeh BDS, MDS
Article Category: Research Article
Volume/Issue: Volume 53: Issue 3
Online Publication Date: Jan 01, 2006
DOI: 10.2344/0003-3006(2006)53[78:AOCPIA]2.0.CO;2
Page Range: 78 – 82

Postoperative sequelae to third-molar surgery include pain, trismus, and buccal swelling. 1 Acute inflammation, which develops as a consequence of the surgical manipulation of the hard and soft tissues, is the principal cause of these signs and symptoms. 2 Analgesics are commonly prescribed to alleviate pain induced by inflammation. 1 The analgesic agent tramadol is increasingly being used for the management of pain associated with acute and chronic inflammatory conditions. 3 4 It is neither a nonsteroidal anti-inflammatory drug (NSAID

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Figure 1 ; Analgesic prodrugs, codeine and tramadol, require metabolism by CYP 2D6 to their active metabolites, morphine and o-desmethyltramadol, respectively. CYP2D6 inhibition by SSRIs (fluoxetine, paroxetine) may result in inadequate analgesia. From Hersh EV, Moore PA. JADA. 2004;135:298–311.
Mana Saraghi,
 Leonard Golden, and
 Elliot V. Hersh
<bold>Figure 1</bold>
Figure 1

Analgesic prodrugs, codeine and tramadol, require metabolism by CYP 2D6 to their active metabolites, morphine and o-desmethyltramadol, respectively. CYP2D6 inhibition by SSRIs (fluoxetine, paroxetine) may result in inadequate analgesia. From Hersh EV, Moore PA. JADA. 2004;135:298–311.


Kazumasa Kubota DDS, PhD,
 Tomoyuki Miyamoto DDS,
 Takutoshi Inoue DDS, and
 Haruhisa Fukayama DDS, PhD
Article Category: Research Article
Volume/Issue: Volume 65: Issue 2
Online Publication Date: Jan 01, 2018
Page Range: 106 – 110

-induced ventilatory impairment, nausea, and/or vomitting. 8 – 10 In patients undergoing maxillofacial surgeries that remodel the upper airway and extra-airway tissues, particularly when they have often undergone intermaxillary fixation, which inhibits maintenance of airway patency and proper drainage, these medications should be carefully administered with appropriate monitoring. 11 Weak opioids, such as tramadol, with or without added acetaminophen, are effective for control of dental pain, 12 but their use may be associated with nausea as an adverse effect. 13 Submucosal

Mana Saraghi DMD,
 Leonard Golden MD, and
 Elliot V. Hersh DMD, MS, PhD
Article Category: Other
Volume/Issue: Volume 65: Issue 1
Online Publication Date: Jan 01, 2018
Page Range: 60 – 65

substrate of CYP 2D6. 6 A notable interaction with CYP 2D6 in the postoperative period concerns the administration of analgesics for postoperative pain containing codeine or tramadol ( Figure 1 ). Both codeine and tramadol are prodrugs that require metabolism by CYP 2D6 to their active metabolites, morphine and o-desmethyltramadol, respectively. Inhibition of CYP 2D6 will reduce the amount of prodrug that is converted to active drug, resulting in inadequate analgesia. 7 , 8 The prescription of such prodrugs should be avoided in patients taking known CYP 2D6 inhibitors

Daniel E. Becker DDS and
 James C. Phero DMD
Article Category: Other
Volume/Issue: Volume 52: Issue 4
Online Publication Date: Jan 01, 2005
Page Range: 140 – 149

attractive choice for patients having a prior history of opioid abuse because it does not provide significant euphoric effects mediated by conventional mu agonists. Tramadol Tramadol is a centrally-acting analgesic with binary action. It is not classified as a controlled substance in the United States. The parent drug inhibits the reuptake of norepinephrine and serotonin. This resembles the action of tricyclic antidepressants and potentiates descending inhibitory pathways illustrated in Figure 1 . This action has proven efficacy in the

Daniel E. Becker DDS
Article Category: Research Article
Volume/Issue: Volume 57: Issue 2
Online Publication Date: Jan 01, 2010
Page Range: 67 – 79

, constipation is unlikely. Tramadol Tramadol is a centrally acting analgesic with binary action. It is not classified as a controlled substance in the United States. The parent drug inhibits the reuptake of norepinephrine and serotonin. This resembles the action of tricyclic antidepressants and potentiates descending neural pathways that inhibit incoming nociceptive impulses. This action has proven efficacy in the management of chronic pain. However, any benefit for tramadol in acute postoperative pain management is not as well

Yuki Kojima DDS, PhD,
 Kiichi Furuse MD,
 Takeshi Murouchi MD, PhD,
 Kazuya Hirabayashi MD, PhD,
 Motoi Kato MD, and
 Tatsuhiro Oka MD, PhD
Article Category: Case Report
Volume/Issue: Volume 67: Issue 3
Online Publication Date: Sep 29, 2020
Page Range: 164 – 169

(±20% of baseline) intraoperatively. The surgical procedure was completed in 3 hours and 16 minutes, blood loss was minimal, and the patient was extubated without difficulty while spontaneously breathing and fully awake. Acetaminophen (1000 mg) and tramadol (200 mg) were administered intravenously in the operating room after conclusion of the surgical procedure for additional postoperative analgesia. The immediate postoperative course was uneventful with no episodes of delirium or PONV. Notably antiemetics were not administered intra- or postoperatively. The patient

Saulo Gabriel Moreira Falci PhD,
 Thiago César Lima DDS,
 Carolina Castro Martins PhD,
 Cássio Roberto Rocha dos Santos PhD, and
 Marcos Luciano Pimenta Pinheiro PhD
Article Category: Research Article
Volume/Issue: Volume 64: Issue 3
Online Publication Date: Jan 01, 2017
Page Range: 136 – 143

), nonsteroidal anti-inflammatories (NSAIDs), and opioid analgesics. 6 , 7 Dexamethasone and methylprednisolone are the most commonly used corticosteroids for preemptive analgesia. 7 NSAIDs, such as diclofenac and ibuprofen, 8 , 9 and central-acting analgesics, such as tramadol, 10 , 11 have also been studied when used preemptively in surgical procedures involving third molars. The effectiveness of preemptive analgesia with the use of corticosteroids and NSAIDs has been demonstrated in previous studies that used either a placebo or different doses of the

David B. Guthrie DMD,
 Martin R. Boorin DMD,
 Andrew R. Sisti BA,
 Ralph H. Epstein DDS,
 Jamie L. Romeiser MPH,
 David K. Lam MD, DDS, PhD,
 Tong J. Gan MD, MBA, MHS, and
 Elliott Bennett-Guerrero MD
Article Category: Research Article
Volume/Issue: Volume 68: Issue 1
Online Publication Date: Apr 07, 2021
Page Range: 3 – 9

minutes vs 37 minutes for dexmedetomidine and 54 minutes for ketamine). Hemodynamic variables, such as HR and MAP, were more stable and remained closer to baseline values in the admixture group compared with those receiving dexmedetomidine (lower HR and MAP) or ketamine alone (higher HR and blood pressure). Zor et al 17 reported similar efficacy for an IM KD admixture in adult patients requiring burn dressing changes. In this study, 24 patients were randomly assigned to receive IM ketamine alone (2 mg/kg); IM tramadol (1 mg/kg), ketamine (2 mg/kg), and