Tramadol Intravenous Infusion

 

Reference	Description
Alistair G., Jane W., Vincent G., Lynn B. 2011. Injectable Drugs Guide. London:(PhP) Pharmaceutical Press	Patient-controlled analgesia: 1.    Make 500mg (10 mL) tramadol up to 50mL with NaCl 0.9% in a PCA syringe to give a solution containing 10 mg/mL. 2.    The solution should be clear and colourless. Inspect visually for particulate matter or discoloration prior to administration and discard if present. 3.    The usual setting for the PCA device is to deliver a 5-mg bolus with a 5-minute lock-out period. Lower doses are used in patients with renal failure Strength used may vary depending on local policies.   Continuous or intermittent intravenous infusion 1.    Withdraw the required dose and add to a suitable volume of compatible infusion fluid (usually NaCl 0.9% or Gluc 5%). 2.    The solution should be clear and colourless. Inspect visually for particulate matter or discoloration prior to administration and discard if present. 3.    Give by continuous or intermittent IV infusion at a suitable rate via a volumetric infusion device. 4.    Close monitoring of respiratory rate and consciousness is recommended for 30 minutes in patients receiving an initial dose, especially elderly patients or those of low bodyweight.   Stability after preparation: From a microbiological point of view, should be used immediately; however, prepared infusions may be stored at 2-8°C and infused (at room temperature) within 24 hours.
https://anaesthesia.org.au/pain/pdf/Tramadol%20in%20Pain%20Management.pdf	IV injection/Infusion via Alaris® Infusion Pump: (for severe pain if oral medications are not suitable eg/ post-operatively). ·       Preferably give as a IV infusion to reduce nausea: ·       Dilute 50-100mg dose with 50-100mL of compatible solution and infuse over 30 -60 mins ·       IV Infusion may be given faster (over 15mins) but is likely to cause nausea Loading dose of 100 mg - usually given during surgery, followed by 50 to 100 mg every 4 to 6 hours. ·       If necessary give as a bolus IV injection over 3-5minutes (nausea, vomiting and dizziness more common with injection) ·       Compatible Solutions: glucose 5%, sodium chloride 0.9%, Hartmann’s, Ringers.
https://www.medicines.org.uk/emc/product/4405/smpc#gref   https://mri.cts-mrp.eu/human/downloads/PT_H_1548_001_FinalPI_2of3.pdf	Tramadol Hydrochloride solution for injection/infusion can be mixed with the following diluents for infusion over the concentration range of 0.5 - 4.0 mg/ml. • 0.9% Sodium Chloride Intravenous Infusion • 5% Dextrose Intravenous Infusion • 0.18% Sodium Chloride and 4% Dextrose Intravenous Infusion • Ringer Lactate Solution • Haemaccel   Shelf-life in use: In use: Tramadol Hydrochloride solution for injection/infusion was found to be physically compatible and chemically stable at controlled room temperature (i.e. 15-25°C) for up to 24 hours with 4.2% Sodium Bicarbonate Solution and Ringer's solution or up to 5 days when mixed with the diluents as given in section 6.6. From a microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would not normally be longer than 24 hours at 2 to 8°C, unless dilution has taken place in controlled and validated aseptic conditions.
Dilution Protocol 1st Edition 2017, Jabatan Kesihatan Negeri Selangor	IV infusion ·       Dilute with suitable volume of diluents ·       Diluent: NS, D5 ·       Administer at a suitable rate
https://www.rch.org.au/anaes/pain_management/Opioid_Infusion/	(Paediatrics) ·       Add 4mg/kg to a total of 50 mL diluent of choice (any IV maintenance solution of electrolytes and/or glucose) to make infusion ·       Infuse at 0-4mL/hr: equivalent to 0-0.32mg/kg/hr ·       Recommend bolus for pain or painful procedures: 1-2mL (0.08-0.16 mg/kg) of infusion at intervals of no less than 10 minutes   Prepared on 02.09.2021 (J. Ho)