Oral Tapentadol as a premedication for the perioperative management of cardiac surgery

Abstract

Background: Tapentadol is a newly introduced analgesic drug from opioid group. Our goal is to study effect of oral tapentadol as premedication drug for intraoperative analgesia and studying its effect on hemodynamics during adult cardiac surgery . Material and Methods: 50 Patients were randomly allocated into two Groups. Group T (N=25) received Oral Tapentadol 50 mg along with Tab. Diazepam 5 mg 1 hour before taking patient inside cardiac operation theatre. Group P (n=25) received placebo tablet with Tab. Diazepam 5 mg similarly. Patients were monitored for pain score experienced while inserting veinflow, the arterial pressure monitoring cannula and central venous catheter. Patients were monitored for intraoperative hemodynamic parameters such as SpO2, heart rate, arterial blood pressure, pulmonary artery pressure. All the patients were monitored for BIS for monitoring depth of anesthesia, urine output. They were also observed for overall requirement of anesthetic drugs and blood products requirement. Extubation time after shifting and rate of complications were observed as well. Observation and Results: There was significant less pain score after line insertion in group T . In group T heart rate and arterial blood pressure was remaining stable throughout the surgery which was significant. Pulmonary artery pressure remains stable in comparison with placebo group .Side effects were less and quite acceptable in terms of severity. Depth of anaesthesia was better maintained in group T. It even reduces requirement of induction agents and maintenance agents as well. Post operative outcome was quite impressive in group T. Conclusion: Oral tapentadol is very much helpful as premedication and as perioperative analgesic drug. Tapentadol helps for early extubation, reduces hospital length stay and provides better postoperative outcome.