Research Article
BibTex RIS Cite

Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits

Year 2024, Volume: 28 Issue: 4, 1124 - 1134, 28.06.2025

Abstract

Tramadol and remifentanil, which is an opioid analgesic are known to have a local anesthetic effect and the present study aimed to evaluate the local anesthetic efficacy of them on twenty-five adult male rabbits Oryctolagus cuniculus (aged between 10-12 months and weighing 1.5±0.08g) who were divided into five groups received the following treatment subcutaneously for 5 days; G1: 5% Tramadol 15 mg/kg BW; G2: 2% Remifentanil 2 mg/kg BW; G3: 2% Lidocaine 4 mg/kg BW; G4: 2% Remifentanil with epinephrine 0.00l mg/kg BW; and G5:2% Remifentanil with Carbopol gel 2 mg/kg BW. Baseline, pre-anesthetic, and post-anesthetic physiological parameters, including temperature, respiratory rate, and heart rate, were meticulously recorded for all groups following local administration of lidocaine, tramadol, and remifentanil. The results showed that tramadol caused a significant decrease in the temperature while other groups showed non-significant effect, results also revealed that pain evaluation that performed according to Grimace Scale scores and by the behavioral analysis of pain assessment elucidated that Lidocaine treatment group showed a statistically significant lower pain response compared to the Tramadol and Remifentanil groups and further significant improvement in pain were observed with the addition of epinephrine or Carbopol gel to Remifentanil. Both combinations resulted in a statistically significant decrease in pain parameters for all measured features comparing with Tramadol and Remifentanil groups and these results leads to conclude that tramadol and remifentanil showed a comparable anaesthetic effect that improved significantly with epinephrine or carbopol gel as local anaesthetics that may surpass lidocaine local anaesthetic effect significantly.

References

  • [1] Cepeda MS, Lau J, Carr DB. Defining the therapeutic role of local anesthetic sympathetic blockade in complex regional pain syndrome: A narrative and systematic review. Clin J Pain. 2002;18(4):216-233. https://doi.org/10.1097/00002508-200207000-00002
  • [2] Mock CN, Donkor P, Gawande A, Jamison DT, Kruk ME, Debas HT; DCP3 Essential Surgery Author Group. Essential surgery: Key messages from Disease Control Priorities, 3rd edition. Lancet. 2015;385(9983):2209-19. https://doi.org/10.1016/s0140-6736(15)60091-5
  • [3] Taylor A, McLeod G. Basic pharmacology of local anaesthetics. BJA Educ. 2020;20(2):34-41. https://doi.org/10.1016%2Fj.bjae.2019.10.002
  • [4] Kitson A, Harvey G, McCormack B. Enabling the implementation of evidence based practice: A conceptual framework. Qual Health Care. 1998;7(3):149-158. https://doi.org/10.1136/qshc.7.3.149
  • [5] Bourne E, Wright C, Royse C. A review of local anesthetic cardiotoxicity and treatment with lipid emulsion. Local Reg Anesth. 2010;3:11-19. https://doi.org/10.2147%2Flra.s8814
  • [6] Shipton EA. New formulations of local anaesthetics-part I. Anesthesiol Res Pract. 2012;2012:546409. https://doi.org/10.1155%2F2012%2F546409
  • [7] Weiniger CF, Golovanevski M, Sokolsky-Papkov M, Domb AJ. Review of prolonged local anesthetic action. Expert Opin Drug Deliv. 2010;7(6):737-752. https://doi.org/10.1517/17425241003767383
  • [8] Wang J, Zhao G, Song G, Liu J. The efficacy and safety of local anesthetic techniques for postoperative analgesia after cesarean section: A Bayesian network meta-analysis of randomized controlled trials. J Pain Res. 2021;14:1559-1572. https://doi.org/10.2147%2FJPR.S313972
  • [9] Fernandez E, Milburn TW. Sensory and affective predictors of overall pain and emotions associated with affective pain. Clin J Pain. 1994;10(1):3-9. https://doi.org/10.1097/00002508-199403000-00002
  • [10] Craig KD, MacKenzie NE. What is pain: Are cognitive and social features core components? Paediatr Neonatal Pain. 2021;3(3):106-118. https://doi.org/10.1002/pne2.12046
  • [11] Yanagidate F, Strichartz GR. Local anesthetics. Handb Exp Pharmacol. 2007;(177):95-127. https://doi.org/10.1007/978-3-540-33823-9_4
  • [12] Dinakar K R, Sanji N, Ravishankar RB, Vidya HK, Shashikala G H. Comparative study of variations in blood pressure and heart rate among normotensive patients and hypertensive patients receiving angiotensin receptor blockers during surgery under spinal anesthesia. Natl J Physiol Pharm Pharmacol. 2018; 8(12): 1581-1586. http://dx.doi.org/10.5455/njppp.2018.8.0827106092018
  • [13] Dwivedi MB, Nagrale M, Dwivedi S, Singh H. What happens to the hemodynamic responses for laryngeal mask airway insertion when we supplement propofol with butorphanol or fentanyl for induction of anesthesia: A comparative assessment and critical review. Int J Crit Illn Inj Sci. 2016 6(1):40-44. https://doi.org/10.4103%2F2229-5151.177369
  • [14] Alappat AM, Lagoo JY, Shivappagoudar V. Evaluation of haemodynamic stability following induction of general anaesthesia with propofol and etomidate in normotensive and hypertensive patients: A comparative study. Glob J Res Anal. 2020;9(10): 117-122. http://dx.doi.org/10.36106/gjra/7510742
  • [15] Bhatia A, Buvanendran A. Anesthesia and postoperative pain control-multimodal anesthesia protocol. J Spine Surg. 2019;5(Suppl 2):S160-S165. https://doi.org/10.21037/jss.2019.09.33.
  • [16] Hosseinzadeh H, Eidy M, Golzari SE, Vasebi M. Hemodynamic stability during ınduction of anesthesia in elderly patients: Propofol + ketamine versus propofol + etomidate. J Cardiovasc Thorac Res. 2013;5(2):51-54. https://doi.org/10.5681%2Fjcvtr.2013.011
  • [17] Epstein-Barash H, Shichor I, Kwon AH, Hall S, Lawlor MW, Langer R, Kohane DS. Prolonged duration local anesthesia with minimal toxicity. Proc Natl Acad Sci U S A. 2009;106(17):7125-7130. https://doi.org/10.1073/pnas.0900598106
  • [18] Kaufman E, Epstein JB, Gorsky M, Jackson DL, Kadari A. Preemptive analgesia and local anesthesia as a supplement to general anesthesia: a review. Anesth Prog. 2005;52(1):29-38. https://doi.org/10.2344%2F0003-3006(2005)52%5B29%3APAALAA%5D2.0.CO%3B2
  • [19] Bagshaw KR, Hanenbaum CL, Carbone EJ, Lo KW, Laurencin CT, Walker J, Nair LS. Pain management via local anesthetics and responsive hydrogels. Ther Deliv. 2015;6(2):165-176. https://doi.org/10.4155%2Ftde.14.95
  • [20] Cherobin ACFP, Tavares GT. Safety of local anesthetics. An Bras Dermatol. 2020 ;95(1):82-90. https://doi.org/10.1016%2Fj.abd.2019.09.025
  • [21] Ring ME. The history of local anesthesia. J Calif Dent Assoc. 2007;35(4):275-82.
  • [22] Barakat A. Revisiting tramadol: A multi-modal agent for pain management. CNS Drugs. 2019;33(5):481-501. https://doi.org/10.1007/s40263-019-00623-5
  • [23] Bidwell LA, Bramlage LR, Rood WA. Equine perioperative fatalities associated with general anaesthesia at a private practice--a retrospective case series. Vet Anaesth Analg. 2007;34(1):23-30. https://doi.org/10.1111/j.1467-2995.2005.00283.x
  • [24] Santonocito C, Noto A, Crimi C, Sanfilippo F. Remifentanil-induced postoperative hyperalgesia: current perspectives on mechanisms and therapeutic strategies. Local Reg Anesth. 2018;11:15-23. https://doi.org/10.2147/lra.s143618
  • [25] Saxena S, Gonsette K, Terram W, Huybrechts I, Nahrwold DA, Cappello M, Barvais L, Engelman E. Gradual withdrawal of remifentanil delays initial post-operative analgesic demand after thyroid surgery; double-blinded, randomized controlled trial. BMC Anesthesiol. 2019;19(1):60. https://doi.org/10.1186/s12871-019-0731-9
  • [26] Vazzana M, Andreani T, Fangueiro J, Faggio C, Silva C, Santini A, Garcia ML, Silva AM, Souto EB. Tramadol hydrochloride: pharmacokinetics, pharmacodynamics, adverse side effects, co-administration of drugs and new drug delivery systems. Biomed Pharmacother. 2015;70:234-238. https://doi.org/10.1016/j.biopha.2015.01.022
  • [27] Scott LJ, Perry CM. Tramadol: a review of its use in perioperative pain. Drugs. 2000;60(1):139-176. https://doi.org/10.2165/00003495-200060010-00008
  • [28] Shah J, Nair AB, Shah H, Jacob S, Shehata TM, Morsy MA. Enhancement in antinociceptive and anti-inflammatory effects of tramadol by transdermal proniosome gel. Asian J Pharm Sci. 2020;15(6):786-796. https://doi.org/10.1016/j.ajps.2019.05.001
  • [29] Akbar H, Khan MA, Bokhari SG, Khan HM, Anjum AA. Comparative efficacy of medetomidine HCl and lignocaine HCl as epidural anesthetic in buffalo calves. Pak Vet J. 2014;34(3):377-380
  • [30] Kang Z, Zhu G, Su C, Zeng K, Li S, Wu X. Differential effects of remifentanil and sufentanil anesthesia on post-operative pain and cognitive functions. Int Immunopharmacol. 2022;108:108888. https://doi.org/10.1016/j.intimp.2022.108888
  • [31] Chinyanga HM. Temperature regulation and anesthesia. Pharmacol Ther. 1984;26(2):147-161. https://doi.org/10.1016/0163-7258(84)90014-7
  • [32] Jeong CW, Lee SH, Ju J, Jeong SW, Lee HG. The effect of priming injection of different doses of remifentanil on injection pain of microemulsion propofol premixed with lidocaine. Korean J Anesthesiol. 2011;60(2):78-82. https://doi.org/10.4097%2Fkjae.2011.60.2.78
  • [33] Jæger P, Koscielniak-Nielsen ZJ, Hilsted KL, Grevstad U, Siersma V, Fabritius ML, Dahl JB. Effect of total dose of lidocaine on duration of adductor canal block, assessed by different test methods: A report of two blinded, randomized, crossover studies in healthy volunteers. Anesth Analg. 2016;123(4):1026-1032. https://doi.org/10.1213/ane.0000000000001517
  • [34] Di Bona D, Plaia A, Scafidi V, Leto-Barone MS, Di Lorenzo G. Efficacy of sublingual immunotherapy with grass allergens for seasonal allergic rhinitis: A systematic review and meta-analysis. J Allergy Clin Immunol. 2010;126(3):558-566. https://doi.org/10.1016/j.jaci.2010.06.013
  • [35] Ide S, Minami M, Ishihara K, Uhl GR, Sora I, Ikeda K. Mu opioid receptor-dependent and independent components in effects of tramadol. Neuropharmacology. 2006;51(3):651-658. https://doi.org/10.1016/j.neuropharm.2006.05.008
  • [36] Nowoczyn M, Marie N, Coulbault L, Hervault M, Davis A, Hanouz JL, Allouche S. Remifentanil produces cross-desensitization and tolerance with morphine on the mu-opioid receptor. Neuropharmacology. 2013;73:368-379. https://doi.org/10.1016/j.neuropharm.2013.06.010
  • [37] Yu S, Wang B, Zhang J, Fang K. The development of local anesthetics and their applications beyond anesthesia. Int J Clin Exp Med. 2019;12(12):13203-13220.‏
  • [38] Grond S, Meuser T, Zech D, Hennig U, Lehmann KA. Analgesic efficacy and safety of tramadol enantiomers in comparison with the racemate: A randomised, double-blind study with gynaecological patients using intravenous patient-controlled analgesia. Pain. 1995;62(3):313-320. https://doi.org/10.1016/0304-3959(94)00274-i
  • [39] Lee SK, Jeong MA, Sung JM, Yeon HJ, Chang JH, Lim H. Effect of remifentanil infusion on the hemodynamic response during induction of anesthesia in hypertensive and normotensive patients: A prospective observational study. J Int Med Res. 2019;47(12):6254-6267. https://doi.org/10.1177%2F0300060519883568
  • [40] Thomas RD, Behbehani MM, Coyle DE, Denson DD. Cardiovascular toxicity of local anesthetics: An alternative hypothesis. Anesth Analg. 1986;65(5):444-450.
  • [41] Wu TY, Wu WT, Lee RP, Chen IH, Yu TC, Wang JH, Yeh KT. tramadol may ıncrease risk of hip fracture in older adults with post-traumatic osteoarthritis. J Pers Med. 2023;13(4):580. https://doi.org/10.3390/jpm13040580
  • [42] Konefał H, Jaskot B, Czeszyńska MB, Pastuszka J. Remifentanil patient-controlled analgesia for labor - monitoring of newborn heart rate, blood pressure and oxygen saturation during the first 24 hours after delivery. Arch Med Sci. 2013;9(4):697-702. https://doi.org/10.5114%2Faoms.2012.31306
  • [43] Marques-Ferreira M, Carrilho E, Paulo S, Carrilho T, Pedro Figueiredo J, Macedo R. Anaesthesia in dental medicine with local ınfiltrative anaesthetic technique versus diploe anaesthesia delivery systems: Efficacy and behaviour, an experimental study. Acta Med Port. 2017;30(12):848-853. https://doi.org/10.20344/amp.8710
  • [44] Lehmann HS, Musk GC, Laurence M, Hyndman TH, Tuke J, Collins T, Gleerup KB, Johnson CB. Mitigation of electroencephalographic and cardiovascular responses to castration in Bos indicus bulls following the administration of either lidocaine or meloxicam. Vet Anaesth Analg. 2017;44(6):1341-1352. https://doi.org/10.1016/j.vaa.2017.04.009
  • [45] Sabourdin N, Barrois J, Louvet N, Rigouzzo A, Guye ML, Dadure C, Constant I. Pupillometry-guided ıntraoperative remifentanil administration versus standard practice ınfluences opioid use: A randomized study. Anesthesiology. 2017;127(2):284-292. https://doi.org/10.1097/aln.0000000000001705
  • [46] Mansour HS, Ali NS, Abdel Rahman MA. The effect of dexamethasone as an adjuvant in quadratus lumborum block to improves analgesia after laparoscopic cholecystectomy: Controlled randomized study. Egypt J Anaesth. 2024;40(1): 135-142.‏ http://dx.doi.org/10.1080/11101849.2024.2322902
  • [47] Benato L, Rooney NJ, Murrell JC. Pain and analgesia in pet rabbits within the veterinary environment: A review. Vet Anaesth Analg. 2019;46(2):151-162. https://doi.org/10.1016/j.vaa.2018.10.007
  • [48] Reabel SN, Queiroz-Williams P, Cremer J, Langohr IM, da Cunha AF, Hampton CE, Carossino M, Liu CC, Nevarez JG. Comparison of blind and endoscopic-guided orotracheal intubation on laryngeal and tracheal damage in domestic rabbits (Oryctolagus cuniculus). Vet Anaesth Analg. 2022;49(4):398-406. https://doi.org/10.1016/j.vaa.2022.04.003
  • [49] Ozawa S, Cenani A, Sanchez-Migallon Guzman Lv D. Treatment of pain in rabbits. Vet Clin North Am Exot Anim Pract. 2023;26(1):201-227. https://doi.org/10.1016/j.cvex.2022.09.001
  • [50] Reabel SN, Queiroz-Williams P, Cremer J, Hampton CE, Liu CC, da Cunha A, Nevarez JG. Assessment of intramuscular administration of three doses of alfaxalone combined with hydromorphone and dexmedetomidine for endoscopic-guided orotracheal intubation in domestic rabbits (Oryctolagus cuniculus). J Am Vet Med Assoc. 2021;259(10):1148-1153. https://doi.org/10.2460/javma.20.07.0402
  • [51] Guedes PEB, Pinto TM, Corrêa JMX, Niella RV, Dos Anjos CM, de Oliveira JNS, Marques CSDC, de Souza SS, da Silva EB, de Lavor MSL. Efficacy of preemptive analgesia with amantadine for controlling postoperative pain in cats undergoing ovariohysterectomy. Animals (Basel). 2024;14(4):643. https://doi.org/10.3390%2Fani14040643
  • [52] Abdullah S, Tokiran MF, Ahmad AA, Soh EZF, Makpol S, Sapuan J. Safety of lidocaine during wide-awake local anesthesia no tourniquet for distal radius plating. J Hand Surg Glob Online. 2023;5(2):196-200. https://doi.org/10.1016/j.jhsg.2022.12.003
  • [53] Anderson TJ, Grégoire J, Pearson GJ, Barry AR, Couture P, Dawes M, Francis GA, Genest J Jr, Grover S, Gupta M, Hegele RA, Lau DC, Leiter LA, Lonn E, Mancini GB, McPherson R, Ngui D, Poirier P, Sievenpiper JL, Stone JA, Thanassoulis G, Ward R. 2016 Canadian Cardiovascular Society Guidelines for the management of dyslipidemia for the prevention of cardiovascular disease in the adult. Can J Cardiol. 2016;32(11):1263-1282. https://doi.org/10.1016/j.cjca.2016.07.510
  • [54] Weggen S, Eriksen JL, Das P, Sagi SA, Wang R, Pietrzik CU, Findlay KA, Smith TE, Murphy MP, Bulter T, Kang DE, Marquez-Sterling N, Golde TE, Koo EH. A subset of NSAIDs lower amyloidogenic Abeta42 independently of cyclooxygenase activity. Nature. 2001;414(6860):212-216. https://doi.org/10.1038/35102591
  • [55] Reed KL, Malamed SF, Fonner AM. Local anesthesia part 2: technical considerations. Anesth Prog. 2012 ;59(3):127-136; quiz 137. https://doi.org/10.2344%2F0003-3006-59.3.127
  • [56] Tuğcu-Demiröz F, Acartürk F, Özkul A. Preparation and characterization of bioadhesive controlled-release gels of cidofovir for vaginal delivery. J Biomater Sci Polym Ed. 2015;26(17):1237-1255. https://doi.org/10.1080/09205063.2015.1082808
  • [57] Geddes IC. Studies with local anaesthetics/I Review of the Literature concerning the methods of comparing Local Anaesthetic Properties. Brit J Anaesth. 1955;27(12): 609 – 615.
  • [58] Jabur MS, Manna MJ, Mohammed HR, Baqir LS, Abdulamir HA. Ocular hypotensive effect for the topical amlodipine 0.5% eye drop. Lat Am J Pharm. 2023;42(special issue): 311-314.
  • [59] Abdulhusseın HA, Alwasıtı EAR, Khıro NK, Nile AK. The potential impact of vascular endothelial growth factor rs699947 polymorphisms on breast tumors susceptibility in a sample of Iraqi females. Acta Pharm Sci. 2024;62:(2): 268-277. https://doi.org/10.23893/1307-2080.APS6217
There are 59 citations in total.

Details

Primary Language English
Subjects Basic Pharmacology
Journal Section Articles
Authors

Nabaa Fadhil Abbas 0009-0004-1458-6513

Raffal A. Omar 0000-0003-4499-8100

Publication Date June 28, 2025
Submission Date April 4, 2024
Acceptance Date April 23, 2024
Published in Issue Year 2024 Volume: 28 Issue: 4

Cite

APA Abbas, N. F., & Omar, R. A. (2025). Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits. Journal of Research in Pharmacy, 28(4), 1124-1134.
AMA Abbas NF, Omar RA. Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits. J. Res. Pharm. July 2025;28(4):1124-1134.
Chicago Abbas, Nabaa Fadhil, and Raffal A. Omar. “Studying the Local Anaesthetic Effects of Lidocaine, Remifentanil (with and Without adjuvants), and Tramadol in Rabbits”. Journal of Research in Pharmacy 28, no. 4 (July 2025): 1124-34.
EndNote Abbas NF, Omar RA (July 1, 2025) Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits. Journal of Research in Pharmacy 28 4 1124–1134.
IEEE N. F. Abbas and R. A. Omar, “Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits”, J. Res. Pharm., vol. 28, no. 4, pp. 1124–1134, 2025.
ISNAD Abbas, Nabaa Fadhil - Omar, Raffal A. “Studying the Local Anaesthetic Effects of Lidocaine, Remifentanil (with and Without adjuvants), and Tramadol in Rabbits”. Journal of Research in Pharmacy 28/4 (July 2025), 1124-1134.
JAMA Abbas NF, Omar RA. Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits. J. Res. Pharm. 2025;28:1124–1134.
MLA Abbas, Nabaa Fadhil and Raffal A. Omar. “Studying the Local Anaesthetic Effects of Lidocaine, Remifentanil (with and Without adjuvants), and Tramadol in Rabbits”. Journal of Research in Pharmacy, vol. 28, no. 4, 2025, pp. 1124-3.
Vancouver Abbas NF, Omar RA. Studying the local anaesthetic effects of lidocaine, remifentanil (with and without adjuvants), and tramadol in rabbits. J. Res. Pharm. 2025;28(4):1124-3.