The Effect of Tramadol Hydrochloride In-traarticular Injection on IL-6 Level in Patients with Tempromandibular Joint Internal Derangement
Affiliation(s)
1 Faculty of Dentistry, Suez Canal University, Isma?lia, Egypt . 2 Faculty of Medicine, Suez Canal University, Isma?lia, Egypt .
1 Faculty of Dentistry, Suez Canal University, Isma?lia, Egypt . 2 Faculty of Medicine, Suez Canal University, Isma?lia, Egypt .
ABSTRACT
Purpose: This study was conducted to detect IL-6 in synovial fluid in cases with TMJ internal derangement. Patients & Methods: This study was conducted on forty patients ASA class I with TMJ Internal derangement. All patients had been subjected to arthrocentesis. The synovial fluid was collected before wash and lavage was done for the affected joint. Then, the selected patients were divided randomly into two equal groups, group I: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml, tramadol hydrochloride. Group II: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml. sodium hyaluronate. Another synovial fluid sample was aspirated after one month. The interlieukin-6 receptors in the aspirated synovial fluid were measured using humans IL-6 enzyme-linked immunosorbent assay. Results: IL-6 was detected in the synovial fluid of joints with internal derangement. During follow up assessment of IL-6, the maximum decrease in IL-6 level was in the patients of group I who subjected to arthrocentesis with tramadol injection, as the mean IL-6 was (4.93 ± 1.36) followed by the patients of group II who subjected to arthrocentesis with sodium hyaluronate injection where the mean IL-6 level was (6.88 ± 1.76). There were significant p-value = (P = 0.000). Conclusions: It had been concluded that the detection of IL-6 in the synovial fluid of joints with internal derangement considered an indicator for inflammatory reaction in the joint and also the efficacy of arthrocentesis with tramadol suggested its anti-inflammatory effect.
Purpose: This study was conducted to detect IL-6 in synovial fluid in cases with TMJ internal derangement. Patients & Methods: This study was conducted on forty patients ASA class I with TMJ Internal derangement. All patients had been subjected to arthrocentesis. The synovial fluid was collected before wash and lavage was done for the affected joint. Then, the selected patients were divided randomly into two equal groups, group I: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml, tramadol hydrochloride. Group II: consisted of 20 patients where arthrocentesis was performed for the affected joint followed by intraarticular injection of one ml. sodium hyaluronate. Another synovial fluid sample was aspirated after one month. The interlieukin-6 receptors in the aspirated synovial fluid were measured using humans IL-6 enzyme-linked immunosorbent assay. Results: IL-6 was detected in the synovial fluid of joints with internal derangement. During follow up assessment of IL-6, the maximum decrease in IL-6 level was in the patients of group I who subjected to arthrocentesis with tramadol injection, as the mean IL-6 was (4.93 ± 1.36) followed by the patients of group II who subjected to arthrocentesis with sodium hyaluronate injection where the mean IL-6 level was (6.88 ± 1.76). There were significant p-value = (P = 0.000). Conclusions: It had been concluded that the detection of IL-6 in the synovial fluid of joints with internal derangement considered an indicator for inflammatory reaction in the joint and also the efficacy of arthrocentesis with tramadol suggested its anti-inflammatory effect.
Cite this paper
El-Gerby, Y. , El-Sholkamy, M. , Abdelhai, A. and Elsharrawy, E. (2015) The Effect of Tramadol Hydrochloride In-traarticular Injection on IL-6 Level in Patients with Tempromandibular Joint Internal Derangement. Pain Studies and Treatment, 3, 31-37. doi: 10.4236/pst.2015.34004.
El-Gerby, Y. , El-Sholkamy, M. , Abdelhai, A. and Elsharrawy, E. (2015) The Effect of Tramadol Hydrochloride In-traarticular Injection on IL-6 Level in Patients with Tempromandibular Joint Internal Derangement. Pain Studies and Treatment, 3, 31-37. doi: 10.4236/pst.2015.34004.
References
[1] Larheim, T.A. (1995) Current Trends in Temporomandibular Joint Imaging. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 80, 555-576. http://dx.doi.org/10.1016/S1079-2104(05)80154-4 [2] Laskin, D.M. (2009) Arthrocentesis for the Treatment of Internal Derangements of the Temporomandibular Joint. Alpha Omegan, 102, 46-50. http://dx.doi.org/10.1016/j.aodf.2009.04.008 [3] Nitzan, D.W., Dolwick, M. and Martinez, G. (1991) Temporomandibular Joint Arthrocentesis: A Simplified Treatment for Sever Limited Mouth Opening. Journal of Oral and Maxillofacial Surgery, 48, 1163. http://dx.doi.org/10.1016/0278-2391(91)90409-F [4] Tuncel, U. (2012) Repeated Sodium Hyaluronate Injections Following Multiple Arthrocentesis in the Treatment of Early Stage Reducing Disc Displacement of the Temporomandibular Joint: A Preliminary Report. Journal of Oral and Maxillofacial Surgery, 40, 685-689. [5] Kapral, S., Gollmann, G., Walt, B., et al. (1999) Tramadol Added to Mepivacaine Prolongs the Duration of Axillary Plexus Blockage. Anesthesia & Analgesia, 88, 853-856. [6] Hiran T. (1998) IL-6 and Its Receptor. International Reviews of Immunology, 16, 249-284. http://dx.doi.org/10.3109/08830189809042997 [7] Nishimura, M., Segami, N., Kaneyama, K. and Suzuki, T. (2001) Prognostic Factors in Arthrocentesis of the Temporomandibular Joint: Evaluation of 100 Patients with Internal Derangement. Journal of Oral and Maxillofacial Surgery, 59, 874-877. http://dx.doi.org/10.1053/joms.2001.25019 [8] Kaneyama, K., Segami, N., Sato, J., Nishimura, M. and Yoshimura, H. (2003) Interleukin-6 Family of Cytokines as Biochemical Markers of Osseous Changes in the Temporomandibular Joint Disorders. British Journal of Oral and Maxillofacial Surgery, 42, 246-250. http://dx.doi.org/10.1016/S0266-4356(03)00258-4 [9] Tamer, A.H. (2012) Arthrocentesis with Injection of Tramadol and Cox-2 Inhibitor for the Management of Internal Derangements of the Tempromandibular Joint (A Comparative Study). Journal of American Science, 8, 66-72. [10] Durval, C.K., Kimiko, S., Adriana, M.I., Olívia, B. and Rogério, S.J. (2009) Edgar Proinflammatory Cytokines in Patients with Neuropathic Pain Treated with Tramadol. Revista Brasileira de Anestesiologia, 59, 3.
[1] Larheim, T.A. (1995) Current Trends in Temporomandibular Joint Imaging. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, 80, 555-576. http://dx.doi.org/10.1016/S1079-2104(05)80154-4 [2] Laskin, D.M. (2009) Arthrocentesis for the Treatment of Internal Derangements of the Temporomandibular Joint. Alpha Omegan, 102, 46-50. http://dx.doi.org/10.1016/j.aodf.2009.04.008 [3] Nitzan, D.W., Dolwick, M. and Martinez, G. (1991) Temporomandibular Joint Arthrocentesis: A Simplified Treatment for Sever Limited Mouth Opening. Journal of Oral and Maxillofacial Surgery, 48, 1163. http://dx.doi.org/10.1016/0278-2391(91)90409-F [4] Tuncel, U. (2012) Repeated Sodium Hyaluronate Injections Following Multiple Arthrocentesis in the Treatment of Early Stage Reducing Disc Displacement of the Temporomandibular Joint: A Preliminary Report. Journal of Oral and Maxillofacial Surgery, 40, 685-689. [5] Kapral, S., Gollmann, G., Walt, B., et al. (1999) Tramadol Added to Mepivacaine Prolongs the Duration of Axillary Plexus Blockage. Anesthesia & Analgesia, 88, 853-856. [6] Hiran T. (1998) IL-6 and Its Receptor. International Reviews of Immunology, 16, 249-284. http://dx.doi.org/10.3109/08830189809042997 [7] Nishimura, M., Segami, N., Kaneyama, K. and Suzuki, T. (2001) Prognostic Factors in Arthrocentesis of the Temporomandibular Joint: Evaluation of 100 Patients with Internal Derangement. Journal of Oral and Maxillofacial Surgery, 59, 874-877. http://dx.doi.org/10.1053/joms.2001.25019 [8] Kaneyama, K., Segami, N., Sato, J., Nishimura, M. and Yoshimura, H. (2003) Interleukin-6 Family of Cytokines as Biochemical Markers of Osseous Changes in the Temporomandibular Joint Disorders. British Journal of Oral and Maxillofacial Surgery, 42, 246-250. http://dx.doi.org/10.1016/S0266-4356(03)00258-4 [9] Tamer, A.H. (2012) Arthrocentesis with Injection of Tramadol and Cox-2 Inhibitor for the Management of Internal Derangements of the Tempromandibular Joint (A Comparative Study). Journal of American Science, 8, 66-72. [10] Durval, C.K., Kimiko, S., Adriana, M.I., Olívia, B. and Rogério, S.J. (2009) Edgar Proinflammatory Cytokines in Patients with Neuropathic Pain Treated with Tramadol. Revista Brasileira de Anestesiologia, 59, 3.