Antagonistic Effects of Ondansetron and Tramadol? A Randomized Placebo and Active Drug Controlled Study

作者：Rauers Neele I; Stuber Frank; Lee Eun Hae; Musshoff Frank; Fimmers Rolf; Barann Martin; Stamer Ulrike M^*

来源：Journal of Pain, 2010, 11(12): 1274-1281.

DOI：10.1016/j.jpain.2010.03.003

• Analgesia emesis tramadol
• ondansetron serotonin

Opposing effects of ondansetron and tramadol on the serotonin pathway have been suggested which possibly increase tramadol consumption and emesis when co-administered In a randomized, double-blinded study, 179 patients received intravenous ondansetron, metoclopramide, or placebo for emesis prophylaxis Analgesic regimen consisted of tramadol intraoperative loading and subsequent patient-controlled analgesia Tramadol consumption and response to antiemetic treatment were compared Additionally, plasma concentrations of ondansetron and (+)O-demethyltramadol and CYP2D6 genetic variants were analyzed as possible confounders influencing analgesic and antiemetic efficacy Tramadol consumption did not differ between the groups Response rate to antiemetic prophylaxis was superior in patients receiving ondansetron (85 0%) compared with placebo (66 7%, P = 046), with no difference to metoclopramide (69 5%) Less vomiting was reported in the immediate postoperative hours in the verum groups (ondansetron 5 0%, metoclopramide 5 1%) compared with placebo (18 6%, P = 01) Whereas plasma concentrations of (+)O-demethyltramadol were significantly correlated to CYP2D6 genotype, no influence was detected for ondansetron Co-administration of ondansetron neither increased tramadol consumption nor frequency of PONV in this postoperative setting
Perspective Controversial findings were reported for efficacy of tramadol and ondansetron when co-administered due to their opposing serotonergic effects Co-medi

• 出版日期2010-12