A Comparative Study of the Analgesic Effect of Patient-Controlled Morphine, Pethidine, and Tramadol for Postoperative Pain Management After Abdominal Hysterectomy

Abstract

We designed this prospective, randomized, double-blind study to compare the analgesic effectiveness and side effects of IV patient-controlled morphine, pethidine, and tramadol for postoperative pain management. One-hundred-twenty-six ASA physical status I or II patients undergoing abdominal hysterectomy were randomly allocated to receive IV-patient controlled morphine (M), pethidine (P), or tramadol (T) for postoperative analgesia. The cumulative analgesic consumption over 24 h was 25.7 +/- 9.5 mg for morphine, 266 +/- 90 mg for pethidine, and 320 +/- 10 mg for tramadol. The average supplementary fentanyl dose used was significantly higher in group T than in groups M and P (P < 0.05). In conclusion, morphine, pethidine, and tramadol resulted in equivalent pain scores and side effects, but tramadol group T required more rescue analgesic doses of fentanyl.

Comparison of patient‐controlled analgesia versus continuous infusion of tramadol in post‐cesarean section pain management

“…Pain scores equivalent to those of morphine were achieved with a lockout interval of 10 min following a 2.5 mg/kg loading dose and an additional tramadol injection of 10 mg, while scores equivalent to both morphine and pethidine were obtained in patients with abdominal hysterectomy by a loading dose of 1 mg/kg with a lockout interval of 10 min and 0.2 mg/kg additional tramadol injection; tramadol use in the latter case was 320 ± 10 mg . In the aftermath of gynecological surgery under general anesthesia, two groups were compared, the first one receiving 3 mg/kg with a lockout interval of 5 min, a bolus dose of 30 mg and a basal infusion of 5 mg/h, and the second group a loading dose of 3 mg/kg and a continuous infusion at the rate of 0.35 mg/h; both groups had equivalent levels of analgesia .…”

Postoperative Analgesia Following Caesarean Section: Intravenous Patient Controlled Analgesia Versus Conventional Continuous Infusion

“…In the literature, superior pain relief with morphine compared to pethidine has been demonstrated in two studies [21,22], while other studies have failed to show any superiority of morphine [23,24]. In one study [25] PCA morphine and pethidine were equally effective for controlling postoperative pain and had similar side effects. Like any other opioid, pethidine is associated with certain unwanted effects, both for the mother and the newborn.…”

Comparison of patient-controlled intravenous analgesia with sufentanil versus tramadol in post&ndash;cesarean section pain management and lactation after general anesthesia &ndash; a prospective, randomized, double-blind, controlled study

“…Intravenous PCA results in lower drug consumption and higher patient satisfaction 1. In addition to the satisfactory level of pain control, reduced rate of respiratory depression, sedation, and effect on intestinal motility of tramadol, this has led to its frequent use in PCA compared to strong opioids 12–14. Sufentanil is the most potent analgesic available at present.…”