Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy

Akbay, Buket Kocaman; Yıldızbaş, Şahnur; Güçlü, Ender; Yılmaz, Süleyman; Iskender, Abdülkadir; Öztürk, Özcan

doi:10.1007/s00540-010-0978-2

Cited by 33 publications

(29 citation statements)

References 15 publications

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“…Peritonsillar infiltration of local anesthetics can cause complications such as bilateral paralysis of vocal cords and severe obstruction of upper airways, acute pulmonary edema (vagus and hypoglossal block), deep neck abscesses, and brainstem stroke, which have been seen after deep infiltration and high doses of local anesthetics (7,11). Peritonsillar infiltration of opioid and ketamine did not lead to any serious complications (10-12,15,18,19,25). …”

Section: Discussionmentioning

confidence: 88%

“…It also decreased analgesic consumption and the time to the beginning of oral liquid diet, while ketamine caused hallucinations and did not have the efficacy of tramadol in pain management and hemodynamic stabilization effects. We used 0.5 mg/kg ketamine and 2 mg/kg tramadol, which has been reported to be an effective and safe dose (10-12,15,18,19,25). …”

Section: Discussionmentioning

confidence: 99%

“…Tramadol is an opium agonist that mostly effects mu receptors, and in smaller extent kappa and sigma receptors, and like anti depressant drugs can inhibit serotonin and norepinephrine reuptake and cause analgesia (6,12,18). Its potency is 5 times lower than morphine (6,12), but it has lower risk of dependency and respiratory depression, without any reported serious toxicity (6,12).…”

mentioning

confidence: 99%

“…However, it has some side effects such as nausea, vomiting, dizziness, sweating, anaphylactic reactions, and increased intra-cerebral pressure. It can also lower the seizure threshold (6,12,18,19). …”

mentioning

confidence: 99%

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Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

et al. 2012

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AimTo assess the effect of peritonsillar infiltration of ketamine and tramadol on post tonsillectomy pain and compare the side effects.MethodsThe double-blind randomized clinical trial was performed on 126 patients aged 5-12 years who had been scheduled for elective tonsillectomy. The patients were randomly divided into 3 groups to receive either ketamine, tramadol, or placebo. They had American Society of Anesthesiologists physical status class I and II. All patients underwent the same method of anesthesia and surgical procedure. The three groups did not differ according to their age, sex, and duration of anesthesia and surgery. Post operative pain was evaluated using CHEOPS score. Other parameters such as the time to the first request for analgesic, hemodynamic elements, sedation score, nausea, vomiting, and hallucination were also assessed during 12 hours after surgery.ResultsTramadol group had significantly lower pain scores (P = 0.005), significantly longer time to the first request for analgesic (P = 0.001), significantly shorter time to the beginning of liquid regimen (P = 0.001), and lower hemodynamic parameters such as blood pressure (P = 0.001) and heart rate (P = 0.001) than other two groups. Ketamine group had significantly greater presence of hallucinations and negative behavior than tramadol and placebo groups. The groups did not differ significantly in the presence of nausea and vomiting.ConclusionPreoperative peritonsillar infiltration of tramadol can decrease post-tonsillectomy pain, analgesic consumption, and the time to recovery without significant side effects.Registration No: IRCT201103255764N2

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

et al. 2012

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“…In one study by Akbay et al that investigated the analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy, they concluded that topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy (27). …”

Section: Discussionmentioning

confidence: 99%

Comparison Between Effect of Lidocaine, Morphine and Ketamine Spray on Post-Tonsillectomy Pain in Children

2012

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BackgroundAn effective pain therapy to block or modify the physiological responses to stress has become an essential component of modern pediatric anesthesia and surgical practice.ObjectivesThe goal of this study was to compare the analgesic effects of the spray forms of; lidocaine, morphine, ketamine, and normal saline on post-tonsillectomy pain scores in children.Patients and MethodsA total of 120 children, American Society of Anesthesiologist (ASA) class I–II, scheduled for elective tonsillectomy were enrolled in this double-blind, clinical trial study. They were randomly divided into 4 groups, each receiving one of the following drugs at the end of operation; lidocaine spray (2 mg/kg); morphine spray (0.05 mg/kg); ketamine spray (0.5 mg/kg); or normal saline spray (8 puffs). For comparison of postoperative pain; the face, legs, activity, cry, consolability (FLACC) pain scale was evaluated during the first one hour of recovery period at 20 minutes intervals. The data was transferred to SPSS-10 software and analyzed statistically with the Scheffe test and Dunnett’s T3 test. P value less than 0.05 was considered significant.ResultsIn the early postoperative period (time: 0) and at 20, 40 and 60 minutes of recovery time, FLACC scale scores in the control group were higher than in the three other groups. At 20 minutes, the FLACC scale score in the lidocaine group was lower than in the other groups. At 40 minutes, the statistical differences between FLACC scales of the lidocaine, morphine and ketamine groups were not significant (P > 0.05). Finally, at 60 minutes, the FLACC scale scores of the ketamine and morphine groups were lower than in the other groups.ConclusionsThe results of this study showed that lidocaine spray had the best pain controlling effect at 20 minutes in the recovery room, but after 40 minutes, ketamine and morphine sprays were more effective than the lidocaine spray.

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A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

Shih

Long

Pecha

et al. 2022

World j. otorhinolaryngol.-head neck surg.

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Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy

Abstract: Topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy.

Cited by 33 publications

References 15 publications

Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

Comparison of peritonsillar infiltration effects of ketamine and tramadol on post tonsillectomy pain: a double-blinded randomized placebo-controlled clinical trial

Comparison Between Effect of Lidocaine, Morphine and Ketamine Spray on Post-Tonsillectomy Pain in Children

A scoping review of randomized clinical trials for pain management in pediatric tonsillectomy and adenotonsillectomy

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