Ciramadol as analgesic adjunct to anesthesia in short surgical procedures

The present study was undertaken to assess the intensity and duration of analgesic effect of ciramadol during induction and maintenance of general anesthesia for short surgical procedures. Sixty female patients received either ciramadol 2 mg.kg-1 or saline before anesthesia induction with thiopental-succinylcholine followed by enflurane maintenance. The changes in heart rate following intubation and surgical incision were partially obtunded by ciramadol pretreatment but mean arterial pressure remained significantly elevated till 6 min. post surgical incision. No evidence of impairment of the spontaneous ventilation was observed even when enflurane anesthesia was added. Addition of enflurane also had no deleterious effects on the cardiovascular performance in the ciramadol treatment group. In the absence of pretreatment with ciramadol, the higher concentrations of enflurane needed induced a significantly lower blood pressure but the rise in heart rate observed remained notably larger than in the ciramadol group. This was accompanied by a reduction of spontaneous ventilation as evidenced by the decrease of minute volume. With both techniques end-tidal carbon dioxide tensions rose to the same extent. Maintenance of adequate anesthesia required a larger amount of enflurane in the non-pretreated group. This could indicate an anesthesia sparing effect of ciramadol.