Comparison of analgesic effect of tramadol alone and a combination of tramadol and paracetamol in day-care laparoscopic surgery.

Author(s): Ali M, Khan FA

Affiliation(s): Department of Anaesthesia, Aga Khan University, Karachi, Pakistan. ali.mohammad@aku.edu

Publication date & source: 2009-06, Eur J Anaesthesiol., 26(6):475-9.

Publication type: Comparative Study; Randomized Controlled Trial

BACKGROUND AND OBJECTIVE: To compare the analgesic efficacy of tramadol alone (1.5 mg kg(-1)) with a tramadol (1 mg kg(-1)) and paracetamol combination in day-care laparoscopic patients. METHODS: The analgesic efficacy of intravenous tramadol alone (1.5 mg kg(-1)) (group T) was compared with a combination of intravenous tramadol (1 mg kg(-1)) and oral paracetamol 1 g (group TP) in 60 day-care laparoscopic patients in a prospective randomized double-blind clinical trial in a tertiary care hospital. Intraoperative haemodynamic responses and postoperative visual analogue scores were used to assess the analgesic efficacy. RESULTS: Only one patient (in group T) received a single dose of rescue analgesia intraoperatively. The highest pain scores were recorded at 30 min postoperatively in both groups, and rescue analgesia was needed in eight patients in group T and in 13 patients in group TP (P = 0.08). The incidence of moderate-to-severe nausea was high in group T (P = 0.001). CONCLUSION: We conclude that reducing the dose of tramadol to 1 mg kg(-1) and combining it with paracetamol 1 g orally decreased the incidence of side effects of tramadol without reducing analgesic efficacy.