The effect of oral tizanidine on postoperative pain relief after elective laparoscopic cholecystectomy

Authors
Reihanak Talakoub
Saeed Abbasi
Elham Maghami
Sayyed Morteza Heidari Tabaei Zavareh
Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Cholecystectomy is considered as the most important and relatively common postoperative pain control often begins in recovery room by using systemic narcotics that may have some side effects. The aim of this study is to evaluate the effect of premedication with oral tizanidine on pain relief after elective laparoscopic cholecystectomy.
Materials and Methods: In this double-blinded clinical trial, 70 adults of American Society of Anesthesiologist physiologic state 1 and 2 scheduled for elective laparoscopic cholecystectomy under general anesthesia were studied and randomly divided in two study and control groups. Ninety minutes before the induction of anesthesia, patients received either 4 mg tizanidine (study group) orally in 50cc or the same volume of plain water as a placebo (control group). Then, the vital signs, pain intensity, duration of stay in recovery, and the analgesic consumption were measured and then compared in both groups during 24 h postoperatively.
Results: There was no significant difference in patient characteristics, with respect to age, weight, gender, and duration of anesthesia and surgery between the groups (P > 0.05). The pain intensity, need for analgesic drugs (34.57 ± 8.88 mg vs. 101.86 ± 5.08 mg), and the duration of stay in recovery room (67.43 ± 1.59 min vs. 79.57 ± 5.48 min) were significantly lower in tizanidine group than that of the control group.
Conclusion: Oral administration of 4 mg tizanidine before laparoscopic cholecystectomy reduces postoperative pain, opioid consumption, and consequence of the duration of stay in recovery room without any complication.
Keywords
Analgesia
laparoscopic cholecystectomy
postoperative pain
tizanidine
1.
Pazuki SH. Evaluation of the effect of metoclopramide infusion on postoperative pain in candidates of cholecystectomy in Tehran Emam Khomeini hospital. Rahavard Danesh 2000;3:6-10.  Back to cited text no. 1
    
2.
Elyasi H, Abdolmohammadi S, Mosaffa F, Madadi F, Dabbagh A. The effect of intra-articular magnesium sulfate on postoperative acute pain in knee arthroscopy. Pajoohandeh J 2009;14:1-4.  Back to cited text no. 2
    
3.
Nouroozi M, Douroodian M, Nashibi M, Ahmadinejad M. Effect of Tizanidine on postoperative pain. J Iran Soc Anaesthesiol Intensive Care 1388;31:24-32.[Persian]  Back to cited text no. 3
    
4.
Christopher L. Acute postoperative pain. In: Miller RD, editor. Anesthesia. 6th ed. Philadelphia: Churchill Livingstone; 2005. p. 2729-62.  Back to cited text no. 4
    
5.
Safarpoor F, Koohsari M. Laparoscopic cholecystectomy: Preferential procedure. Gilan Univ Med J 2002;11:50-5.  Back to cited text no. 5
    
6.
Tverskoy M, Oren M, Vaskovich M, Dashkovsky I, Kissin I. Ketamine enhances local anesthetic and analgesic effects of bupivacaine by peripheral mechanism: A study in postoperative patients. Neurosci Lett 1996;215:5-8.  Back to cited text no. 6
    
7.
Imanaga K, Wajima Z, Inoue T, Ogawa R. Effect of oral tizanidine on local-anesthetic infiltration pain during epidural catheterization. J Nippon Med Sch 2004;71:105-10.  Back to cited text no. 7
    
8.
Henney HR, Chez M. Pediatric safety of tizanidine: Clinical adverse event database and retrospective chart assessment. Paediatr Drugs 2009;11:397-406.  Back to cited text no. 8
    
9.
Wajima Z, Yoshikawa T, Ogura A, Imanaga K, Shiga T, Inoue T, et al. Oral tizanidine, an alpha2-adrenoceptor agonist, reduces the minimum alveolar concentration of sevoflurane in human adults. Anesth Analg 2002;95:393-6.  Back to cited text no. 9
    
10.
Takenaka M, Iida H, Kasamatsu M, Katoh H, Tashiro T, Dohi S. Tizanidine for preanesthetic medication. Masui 1996;45:971-5.  Back to cited text no. 10
    
11.
Turan A, Karamanlioglu B, Memis D, Hamamcioglu MK, Tükenmez B, Pamukçu Z, et al. Analgesic effects of gabapentin after spinal surgery. Anesthesiology 2004;100:935-8.  Back to cited text no. 11
    
12.
Vorobeichik IaM, Kukushkin ML, Reshetniak VK, Ovechkin AM, Gnezdilov AV. The treatment of the phantom pain syndrome with tizanidine. Zh Nevrol Psikhiatr Im S S Korsakova 1997;97:36-9.  Back to cited text no. 12
    
13.
Omote K, Satoh O, Sonoda H, Kumeta Y, Yamaya K, Namiki A. Effects of oral alpha 2 adrenergic agonists, clonidine and tizanidine, on tetracaine spinal anesthesia. Masui 1995;44:816-23.  Back to cited text no. 13
Advanced Biomedical Research
Volume 2016, February
February 2016
Pages 1-6