Preincisional local infiltration of tramadol at the trocar site versus intravenous tramadol for pain control after laparoscopic cholecystectomy.
Author(s): Matkap E, Bedirli N, Akkaya T, Gumus H
Affiliation(s): Department of Anesthesiology and Reanimation, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara 06434, Turkey.
Publication date & source: 2011-05, J Clin Anesth., 23(3):197-201. Epub 2011 Apr 16.
Publication type: Comparative Study; Randomized Controlled Trial
STUDY OBJECTIVE: To compare the effects of preoperative intravenous (IV) tramadol and preoperative tramadol infiltration of trocar sites on postoperative pain and postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy. DESIGN: Prospective, randomized study. SETTING: Operating room, recovery room, and surgical ward. PATIENTS: 70 ASA physical status 1 and 2 patients, aged 20-70 years, scheduled for elective laparoscopic cholecystectomy. INTERVENTIONS: In Group I, patients received IV 2.0 mg/kg of tramadol; in Group II, trocar insertion points were infiltrated with 2.0 mg/kg of tramadol in 20 mL of 0.9% NaCl. MEASUREMENTS: Pain scores, sedation scores, postoperative analgesic requirement, and PONV were recorded at 0 and 30 minutes and one, three, 6, 12, and 24 hours. At 30 minutes and one hour, pain localization (incisional or diffuse abdominal) was also recorded. MAIN RESULTS: Visual analog scale scores at 30 minutes were significantly lower in Group II [3 (0-7)] than Group I [6 (3-8)] (P < 0.001). In Group I, 91.4% of patients received sodium diclofenac, while 68.6% of Group II patients received sodium diclofenac (P = 0.002). The time to first analgesic requirement was significantly lower in Group II (P = 0.004). At the 30-minute measurement time, a significant difference was recorded between the groups in incisional pain (P < 0.001). There was also a significant difference between groups in the frequency of PONV. CONCLUSIONS: Trocar site infiltration of tramadol improves early postoperative pain and decreases PONV. Copyright (c) 2011 Elsevier Inc. All rights reserved.
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