Tramadol: pain relief by an opioid without depression of respiration
Two independent clinical trials were conducted simultaneously. In one, tramadol and pethidine were compared in 30 patients by patient-controlled analgesia during the first 24 h following abdominal surgery. The mean 24 h consumption of tramadol and pethidine was 642 mg and 606 mg respectively, giving...
Saved in:
Published in | Anaesthesia Vol. 47; no. 4; p. 291 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
England
01.04.1992
|
Subjects | |
Online Access | Get more information |
Cover
Loading…
Abstract | Two independent clinical trials were conducted simultaneously. In one, tramadol and pethidine were compared in 30 patients by patient-controlled analgesia during the first 24 h following abdominal surgery. The mean 24 h consumption of tramadol and pethidine was 642 mg and 606 mg respectively, giving a potency estimate of tramadol relative to pethidine of 0.94 (95% confidence interval 0.72-1.17). In the second trial, the effect on respiration of three doses of tramadol (0.5, 1.0, and 2.0 mg.kg-1) was compared with that of morphine sulphate (0.143 mg.kg-1) by intravenous injection during stable halothane anaesthesia. At approximately 1.5 times the equipotent dose, as estimated from the first trial, tramadol transiently depressed the rate of respiration but had no effect on end-tidal carbon dioxide tension. Morphine caused apnoea or considerable depression of ventilation. The results suggest that mechanisms other than opioid receptor activity play a significant role in the analgesia produced by tramadol. |
---|---|
AbstractList | Two independent clinical trials were conducted simultaneously. In one, tramadol and pethidine were compared in 30 patients by patient-controlled analgesia during the first 24 h following abdominal surgery. The mean 24 h consumption of tramadol and pethidine was 642 mg and 606 mg respectively, giving a potency estimate of tramadol relative to pethidine of 0.94 (95% confidence interval 0.72-1.17). In the second trial, the effect on respiration of three doses of tramadol (0.5, 1.0, and 2.0 mg.kg-1) was compared with that of morphine sulphate (0.143 mg.kg-1) by intravenous injection during stable halothane anaesthesia. At approximately 1.5 times the equipotent dose, as estimated from the first trial, tramadol transiently depressed the rate of respiration but had no effect on end-tidal carbon dioxide tension. Morphine caused apnoea or considerable depression of ventilation. The results suggest that mechanisms other than opioid receptor activity play a significant role in the analgesia produced by tramadol. |
Author | Vickers, M D Szekely, S M Yoshizumi, J O'Flaherty, D Read, M |
Author_xml | – sequence: 1 givenname: M D surname: Vickers fullname: Vickers, M D organization: Department of Anaesthetics, University of Wales College of Medicine, Heath Park, Cardiff – sequence: 2 givenname: D surname: O'Flaherty fullname: O'Flaherty, D – sequence: 3 givenname: S M surname: Szekely fullname: Szekely, S M – sequence: 4 givenname: M surname: Read fullname: Read, M – sequence: 5 givenname: J surname: Yoshizumi fullname: Yoshizumi, J |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/1519677$$D View this record in MEDLINE/PubMed |
BookMark | eNotj01LAzEYhHOo1Lb6E4Tgfdd8Z-NN6icUvNRzebPJYsruJiRbtP_eBTuXYXiGgVmjxRhHj9A9JTWd9XCsKVeyYkSImhrD6skSRpWqfxdoRQjhFRPEXKN1KUdCKGtos0RLKqlRWq_Q8z7DAC72jzhBGHH2ffAdtmcMI44pxODwT5i-42nCzqfsSwlxJt3cLClkmOZ4g6466Iu_vfgGfb2-7Lfv1e7z7WP7tKtaKSitnOPgrLRKe2s4sFY3zBMDrOmcta6lTIq2ZSCt5Y1UXBorOHCjwWotBbANuvvfTSc7eHdIOQyQz4fLG_YHFNxPQg |
CitedBy_id | crossref_primary_10_1093_bja_85_2_211 crossref_primary_10_1111_j_1460_9592_2005_01591_x crossref_primary_10_1111_j_1365_2125_1995_tb04460_x crossref_primary_10_18410_jebmh_2018_462 crossref_primary_10_1016_S0966_6532_97_00138_8 crossref_primary_10_1017_S0265021503000206 crossref_primary_10_1097_00000539_200206000_00017 crossref_primary_10_7759_cureus_26839 crossref_primary_10_1111_j_1362_1017_2004_00087_x crossref_primary_10_1007_s11255_007_9297_4 crossref_primary_10_1097_AJP_0b013e3181671a08 crossref_primary_10_1111_j_1365_2125_1997_tb00035_x crossref_primary_10_1213_ANE_0000000000000625 crossref_primary_10_1007_BF03020186 crossref_primary_10_1213_00000539_200301000_00016 crossref_primary_10_4103_ija_IJA_747_17 crossref_primary_10_1097_00000539_200206000_00026 crossref_primary_10_1016_S0011_393X_98_85022_4 crossref_primary_10_1111_j_1365_2044_2007_05038_x crossref_primary_10_1163_156856905774482733 crossref_primary_10_1111_j_1365_2125_1996_tb00168_x crossref_primary_10_1097_00003643_200302000_00011 crossref_primary_10_1017_S0265021503000218 crossref_primary_10_1300_J088v03n01_02 crossref_primary_10_1007_s12663_020_01400_4 crossref_primary_10_1038_s41598_019_48955_y crossref_primary_10_1080_09699260_1996_11746760 crossref_primary_10_1097_EJA_0b013e32831c8988 crossref_primary_10_3760_cma_j_issn_0366_6999_2010_13_015 crossref_primary_10_3389_fphar_2019_01680 crossref_primary_10_4103_0019_5049_193672 crossref_primary_10_1016_j_ijoa_2011_03_002 crossref_primary_10_17245_jdapm_2021_21_3_245 crossref_primary_10_1007_BF03013197 crossref_primary_10_1093_bja_aeg079 crossref_primary_10_1111_j_1365_2044_1995_tb06053_x crossref_primary_10_1155_2013_283425 crossref_primary_10_1016_j_amjmed_2023_10_022 crossref_primary_10_1016_j_jclinane_2011_05_003 crossref_primary_10_1097_00003643_199903000_00008 crossref_primary_10_1097_00003643_199903000_00009 crossref_primary_10_1136_dtb_1994_321185 crossref_primary_10_1016_S0950_3501_05_80327_7 crossref_primary_10_1017_S0265021503000231 crossref_primary_10_1093_bja_aei260 crossref_primary_10_1016_j_jpain_2010_03_003 crossref_primary_10_14260_Jemds_2017_552 crossref_primary_10_3923_ijp_2008_452_459 crossref_primary_10_1089_089277903321196706 crossref_primary_10_14219_jada_archive_2002_0300 crossref_primary_10_1080_003655902320248254 crossref_primary_10_1111_jog_12259 crossref_primary_10_1016_j_urology_2009_06_108 crossref_primary_10_1016_j_clinthera_2006_12_007 crossref_primary_10_1046_j_1365_2044_1999_00739_x crossref_primary_10_1046_j_1365_2044_1998_00526_x crossref_primary_10_3923_tmr_2015_51_62 crossref_primary_10_1007_BF03012091 crossref_primary_10_1155_2011_259426 crossref_primary_10_1016_S1366_0071_98_80001_6 crossref_primary_10_1007_BF03258480 crossref_primary_10_1017_S026502150300022X crossref_primary_10_1017_S0265021508003645 crossref_primary_10_1213_00000539_199808000_00040 crossref_primary_10_4103_njms_NJMS_78_17 crossref_primary_10_1017_S0265021503000243 crossref_primary_10_1016_j_pharma_2010_03_004 crossref_primary_10_1016_0304_3959_94_00274_I crossref_primary_10_1016_S0889_8537_05_70332_1 crossref_primary_10_1016_0304_3959_95_00056_X crossref_primary_10_1007_BF03017896 crossref_primary_10_1089_adt_2016_760 crossref_primary_10_1016_j_tvjl_2008_11_002 crossref_primary_10_1007_BF03024867 crossref_primary_10_1016_0006_8993_95_00990_5 crossref_primary_10_5847_wjem_j_issn_1920_8642_2014_04_006 crossref_primary_10_1016_j_chroma_2004_04_031 crossref_primary_10_18231_j_ijca_2022_044 crossref_primary_10_1017_S0265021503000255 crossref_primary_10_2147_NSS_S348834 crossref_primary_10_2460_javma_238_2_220 crossref_primary_10_1111_j_1460_9592_2010_03296_x crossref_primary_10_1111_j_0265_0215_1998_00271_x crossref_primary_10_7759_cureus_20781 crossref_primary_10_1007_s00520_004_0720_4 crossref_primary_10_1016_j_rvsc_2010_07_015 crossref_primary_10_1097_00000539_200106000_00039 crossref_primary_10_2165_00003495_200666180_00005 crossref_primary_10_1016_S0024_3205_02_02345_7 crossref_primary_10_1097_00003643_200201000_00007 crossref_primary_10_1093_bja_aeg064 crossref_primary_10_1520_JFS13776J crossref_primary_10_1177_0897190003258505 crossref_primary_10_1017_S0265021503000267 crossref_primary_10_1097_00003643_199809000_00010 crossref_primary_10_1097_SCS_0000000000004393 crossref_primary_10_1017_S0265021503240308 crossref_primary_10_1046_j_1365_2044_2002_2457_3_x crossref_primary_10_1186_s40780_016_0059_2 crossref_primary_10_1177_147323000303100605 crossref_primary_10_1016_j_urology_2009_08_041 crossref_primary_10_1177_108925320500900102 crossref_primary_10_1002_j_1875_9114_1998_tb03154_x crossref_primary_10_1016_S1090_3801_99_90047_2 crossref_primary_10_1093_bja_aei214 crossref_primary_10_1017_S0265021503000279 crossref_primary_10_1208_pt040331 crossref_primary_10_1017_S0265021503001480 crossref_primary_10_1017_S0265021503230301 crossref_primary_10_1300_J088v01n02_02 crossref_primary_10_1016_S1366_0071_00_80026_1 crossref_primary_10_1046_j_1460_9592_2003_01214_x crossref_primary_10_1097_00000542_199709001_00789 crossref_primary_10_1097_01_aco_0000192803_40914_53 crossref_primary_10_1016_j_dld_2013_07_020 crossref_primary_10_1097_00003643_199907000_00007 crossref_primary_10_1097_00003643_200007000_00007 crossref_primary_10_1007_s10792_016_0184_9 crossref_primary_10_1034_j_1399_6576_2002_460817_x crossref_primary_10_1016_j_jss_2019_10_002 crossref_primary_10_1016_j_acpain_2006_03_001 crossref_primary_10_1017_S0265021503000164 crossref_primary_10_1053_j_jvca_2005_05_013 crossref_primary_10_1017_S0265021503000280 crossref_primary_10_1016_S0952_8180_97_00147_5 crossref_primary_10_1590_S0103_84782006000100023 crossref_primary_10_1111_anae_15650 crossref_primary_10_1017_S1049023X0003747X crossref_primary_10_1007_s00383_008_2147_3 crossref_primary_10_1017_S0265021503210309 crossref_primary_10_1093_chromsci_bms066 crossref_primary_10_1097_00003643_199801000_00013 crossref_primary_10_1111_j_1742_1241_1998_tb11579_x crossref_primary_10_1016_S0750_7658_98_80036_1 crossref_primary_10_1016_S1090_3801_98_90032_5 crossref_primary_10_1111_j_2042_3306_2012_00654_x crossref_primary_10_1002_14651858_CD011185_pub2 crossref_primary_10_1590_S0102_09352008000300014 crossref_primary_10_1017_S0265021503000176 crossref_primary_10_1093_bja_ael155 crossref_primary_10_1016_j_clinthera_2006_10_001 crossref_primary_10_2165_00003088_200443130_00004 crossref_primary_10_1111_j_1742_1241_1996_tb09527_x crossref_primary_10_1017_S0265021503000292 crossref_primary_10_1046_j_1460_9592_2001_00694_x crossref_primary_10_1016_j_ijoa_2013_05_009 crossref_primary_10_2337_diabetes_50_12_2815 crossref_primary_10_1097_00000539_199607000_00015 crossref_primary_10_1007_s12070_012_0571_0 crossref_primary_10_1016_S0091_3057_98_00123_3 crossref_primary_10_1016_S1366_0071_02_00025_6 crossref_primary_10_1177_1078155209348249 crossref_primary_10_1017_S0265021503000188 crossref_primary_10_1017_S0265021503250304 crossref_primary_10_1016_j_douler_2009_01_007 crossref_primary_10_1097_00003643_199912000_00004 crossref_primary_10_1111_j_1460_9592_2005_01740_x crossref_primary_10_3390_ph17020205 crossref_primary_10_1016_S0378_4347_97_00605_1 crossref_primary_10_14260_jemds_1118 crossref_primary_10_1177_00912709922008362 crossref_primary_10_2165_00003495_200060010_00008 crossref_primary_10_1097_00003643_200305000_00012 crossref_primary_10_1163_1568569042664387 crossref_primary_10_1016_S0735_6757_97_90116_9 crossref_primary_10_1097_00003643_200311000_00011 crossref_primary_10_4103_aer_AER_127_19 crossref_primary_10_1007_BF03013907 crossref_primary_10_1111_j_1399_6576_2005_00790_x crossref_primary_10_1111_j_1365_2125_1997_tb00140_x crossref_primary_10_1016_j_jos_2016_07_011 crossref_primary_10_1017_S026502150300019X crossref_primary_10_1177_147323000803600513 crossref_primary_10_1016_j_jpba_2008_10_030 crossref_primary_10_1111_1440_1681_12274 crossref_primary_10_1016_S0011_393X_98_85059_5 crossref_primary_10_1093_bja_aeg213 crossref_primary_10_1046_j_1365_2044_1999_01046_x crossref_primary_10_14260_Jemds_2017_10 crossref_primary_10_1097_00000539_200301000_00016 crossref_primary_10_1016_S0889_8537_05_70248_0 crossref_primary_10_1080_00016350510019685 crossref_primary_10_1097_00029330_200612010_00012 crossref_primary_10_1016_S0950_3501_95_80022_0 crossref_primary_10_1016_S1607_551X_10_70044_9 crossref_primary_10_1017_S0265021503220305 crossref_primary_10_1007_BF03009627 crossref_primary_10_1016_j_jpain_2019_04_005 crossref_primary_10_1016_S0009_9236_96_90211_8 crossref_primary_10_1097_00000539_199808000_00040 crossref_primary_10_1097_BSD_0b013e31805f6d54 crossref_primary_10_1016_j_jchromb_2021_122971 crossref_primary_10_1213_00000539_200206000_00017 crossref_primary_10_1016_S0740_5472_00_00098_2 crossref_primary_10_1034_j_1399_6576_2001_045006786_x crossref_primary_10_1111_j_1460_9592_2010_03374_x crossref_primary_10_1093_bja_87_6_860 crossref_primary_10_4103_0019_5049_82667 crossref_primary_10_1213_00000539_199607000_00015 crossref_primary_10_1053_bean_2003_0267 crossref_primary_10_1213_00000539_200206000_00026 crossref_primary_10_1017_S0265021505000554 crossref_primary_10_1111_j_1365_2044_2011_06969_x crossref_primary_10_1089_end_2009_0224 crossref_primary_10_1007_s12663_011_0321_y crossref_primary_10_1016_j_egja_2013_05_001 crossref_primary_10_1186_s40064_016_2801_5 crossref_primary_10_1016_S1366_0071_99_80019_9 crossref_primary_10_1177_1558944716677535 crossref_primary_10_1016_j_ijporl_2007_11_002 crossref_primary_10_18663_tjcl_445926 crossref_primary_10_1016_S0304_3959_03_00212_4 crossref_primary_10_1017_S0265021503260300 crossref_primary_10_1002_14651858_CD009574_pub2 crossref_primary_10_1016_S1734_1140_09_70159_8 crossref_primary_10_1016_0028_2243_93_90260_J crossref_primary_10_1213_01_ane_0000196506_28780_94 crossref_primary_10_1097_00003643_199711000_00015 crossref_primary_10_1007_s12663_012_0420_4 crossref_primary_10_1007_s10029_009_0486_1 crossref_primary_10_1177_0310057X0002800403 crossref_primary_10_1046_j_1365_2044_1999_00714_x crossref_primary_10_1007_BF03012458 crossref_primary_10_1007_BF03012579 crossref_primary_10_1177_0310057X0403200103 crossref_primary_10_1016_j_ejphar_2005_11_028 crossref_primary_10_1016_j_clinthera_2009_03_001 crossref_primary_10_1016_S1366_0071_03_00025_1 crossref_primary_10_1097_00003643_199607000_00022 crossref_primary_10_4236_ojanes_2013_31006 crossref_primary_10_1007_s00228_015_1857_4 crossref_primary_10_14219_jada_archive_2005_0059 crossref_primary_10_1590_S1677_55382009000300005 crossref_primary_10_1016_S0952_8180_99_00047_1 crossref_primary_10_1093_oxfordjournals_annonc_a058765 |
ContentType | Journal Article |
DBID | CGR CUY CVF ECM EIF NPM |
DOI | 10.1111/j.1365-2044.1992.tb02166.x |
DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed |
DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) |
DatabaseTitleList | MEDLINE |
Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
DeliveryMethod | no_fulltext_linktorsrc |
ExternalDocumentID | 1519677 |
Genre | Comparative Study Clinical Trial Randomized Controlled Trial Research Support, Non-U.S. Gov't Journal Article |
GroupedDBID | --- .3N .55 .GA .GJ .Y3 05W 0R~ 10A 1OC 23M 24P 31~ 33P 36B 3O- 3SF 4.4 50Y 50Z 51W 51X 52M 52N 52O 52P 52R 52S 52T 52U 52V 52W 52X 53G 5GY 5HH 5LA 5RE 5VS 66C 6J9 6P2 702 7PT 8-0 8-1 8-3 8-4 8-5 8UM 930 A01 A03 AAESR AAEVG AAHHS AANLZ AAONW AAQQT AASGY AAWTL AAXRX AAZKR ABCQN ABCUV ABEML ABJNI ABLJU ABPVW ABQWH ABXGK ACAHQ ACCFJ ACCZN ACGFO ACGFS ACGOF ACMXC ACPOU ACPRK ACSCC ACXBN ACXQS ADBBV ADBTR ADEOM ADIZJ ADKYN ADMGS ADOZA ADXAS ADZMN ADZOD AEEZP AEGXH AEIGN AEIMD AENEX AEQDE AEUQT AEUYR AFBPY AFEBI AFFNX AFFPM AFGKR AFPWT AFRAH AFZJQ AHBTC AHEFC AHMBA AI. AIACR AIAGR AITYG AIURR AIWBW AJBDE ALAGY ALMA_UNASSIGNED_HOLDINGS ALUQN AMBMR AMYDB ATUGU AZBYB AZVAB BAFTC BFHJK BHBCM BMXJE BROTX BRXPI BY8 C45 CAG CGR COF CS3 CUY CVF D-6 D-7 D-E D-F DC6 DCZOG DPXWK DR2 DRFUL DRMAN DRSTM EBS ECM EIF EJD EMOBN ESX EX3 F00 F01 F04 F5P FUBAC FZ0 G-S G.N GODZA H.X HF~ HGLYW HZI HZ~ IHE IX1 J0M J5H K48 KBYEO L7B LATKE LC2 LC3 LEEKS LH4 LITHE LOXES LP6 LP7 LUTES LW6 LYRES MEWTI MK4 MRFUL MRMAN MRSTM MSFUL MSMAN MSSTM MXFUL MXMAN MXSTM N04 N05 N9A NF~ NPM O66 O9- OIG OK1 OVD P2P P2W P2X P2Z P4B P4D PQQKQ Q.N Q11 QB0 R.K ROL RX1 SUPJJ TEORI UB1 V8K V9Y VH1 W8V W99 WBKPD WHWMO WIH WIJ WIK WIN WOHZO WOW WQJ WRC WUP WVDHM WXI WXSBR X7M XG1 YFH YOC YUY ZCG ZGI ZXP ZZTAW ~IA ~WT |
ID | FETCH-LOGICAL-c5411-dd3adb5b67eb93a2c782e09a28fdbbdc1254cc2a5bb3856359b43a397ab7754a2 |
ISSN | 0003-2409 |
IngestDate | Sat Sep 28 08:36:37 EDT 2024 |
IsDoiOpenAccess | false |
IsOpenAccess | true |
IsPeerReviewed | true |
IsScholarly | true |
Issue | 4 |
Language | English |
LinkModel | OpenURL |
MergedId | FETCHMERGED-LOGICAL-c5411-dd3adb5b67eb93a2c782e09a28fdbbdc1254cc2a5bb3856359b43a397ab7754a2 |
OpenAccessLink | https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/j.1365-2044.1992.tb02166.x |
PMID | 1519677 |
ParticipantIDs | pubmed_primary_1519677 |
PublicationCentury | 1900 |
PublicationDate | April 1992 |
PublicationDateYYYYMMDD | 1992-04-01 |
PublicationDate_xml | – month: 04 year: 1992 text: April 1992 |
PublicationDecade | 1990 |
PublicationPlace | England |
PublicationPlace_xml | – name: England |
PublicationTitle | Anaesthesia |
PublicationTitleAlternate | Anaesthesia |
PublicationYear | 1992 |
SSID | ssj0012818 |
Score | 1.9022006 |
Snippet | Two independent clinical trials were conducted simultaneously. In one, tramadol and pethidine were compared in 30 patients by patient-controlled analgesia... |
SourceID | pubmed |
SourceType | Index Database |
StartPage | 291 |
SubjectTerms | Abdomen - surgery Adult Aged Analgesia, Patient-Controlled Double-Blind Method Female Humans Male Meperidine - adverse effects Meperidine - therapeutic use Middle Aged Morphine - therapeutic use Nausea - chemically induced Pain, Postoperative - drug therapy Respiration - drug effects Tramadol - adverse effects Tramadol - therapeutic use |
Title | Tramadol: pain relief by an opioid without depression of respiration |
URI | https://www.ncbi.nlm.nih.gov/pubmed/1519677 |
Volume | 47 |
hasFullText | |
inHoldings | 1 |
isFullTextHit | |
isPrint | |
link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1LS8QwEA4-ELyIouKbHLxW2jTtbr2JD0TQgy-8yUyTYFF3l9WL_npnmmy7iivqpSwNlLbz7fTLzDczQuxyLtNlxkQ2TzHSSakiVImjPQ9LvmOXOOSM7vlFfnqjz-6yu7aEoK4uecW98v3bupL_WJXOkV25SvYPlm0uSifoN9mXjmRhOv7OxkN45pZMvK0fgK9MqaxjSskTJwZVv_LichYfN5rXmiAOQ4p9ZJamnzLQZ-LBvlSNu76tWHnhg9KtPphFMidP8MCteT8Lh9_to_Xjq6_aUOtlgNJ5G2XwitRGnDLynClnYopxz-l7ZQaE6HE36CdwTXbPtbYu1pqLJRVHp1WS5164OWa3wXNtOCIlRe6Hvfy4-KVxdliZFtOdLvu-C47jhPwS98AazVLkpwrtaIPGa8LdzYu5cM0ve5Cai1wvioWwiZAHHhFLYsr2lsXRCA37krEgPRYkvknoSY8FGbAgWyzIvpNjWFgRNyfH14enUZiREZWZTpLImBQMZph3LBYpqJIYn40LUF1nEE1J_FWXpYIMMe1mxC4L1CkQCQXk3oegVsVMr9-za0ISce8WYOMEC-LIoECDNR2wiK7MTJyti1X_0PcD3wjlPryNjUkLm2K-xdKWmHX0v7PbROJecae2xwdMjkJs |
link.rule.ids | 786 |
linkProvider | National Library of Medicine |
openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Tramadol%3A+pain+relief+by+an+opioid+without+depression+of+respiration&rft.jtitle=Anaesthesia&rft.au=Vickers%2C+M+D&rft.au=O%27Flaherty%2C+D&rft.au=Szekely%2C+S+M&rft.au=Read%2C+M&rft.date=1992-04-01&rft.issn=0003-2409&rft.volume=47&rft.issue=4&rft.spage=291&rft_id=info:doi/10.1111%2Fj.1365-2044.1992.tb02166.x&rft_id=info%3Apmid%2F1519677&rft_id=info%3Apmid%2F1519677&rft.externalDocID=1519677 |
thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0003-2409&client=summon |
thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0003-2409&client=summon |
thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0003-2409&client=summon |