Comparison of intravenous and peritonsillar infiltration of tramadol for postoperative pain relief in children following adenotonsillectomy

Akkaya, Taylan; Bedirli, Nurdan; Ceylan, Tijen; Matkap, Erkan; Gülen, Güven; Elverici, Ozan; Gümüş, Haluk; Akın, İstemihan

doi:10.1097/eja.0b013e32831c8988

Cited by 33 publications

(43 citation statements)

References 26 publications

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“…In a study conducted on 75 pediatric herniotomy patients by Demiraran et al [16], 2 mg/kg tramadol used for wound infiltration provides approximately 2 h more analgesia compared to intramuscular tramadol. Similarly, it has been shown that 2 mg/kg tramadol used in peritonsillar infiltration prolongs the postoperative analgesia duration and reduces the need for additional analgesics and the incidence of side effects [4][5][6]. This study has showed that tramadol decreases VAS scores and opioid consumption in a statistically and clinically significant manner in the first 24 h when compared to placebo in the first postoperative 2 h in Group T following local infiltration at the end of surgery.…”

Section: Discussionsupporting

confidence: 50%

“…All the patients were given Patient controlled analgesia (PCA) with 4 mg/ml concentration, 10 mg/h infusion, 20 mg bolus, 15 min lock-out time. Total opioid consumption was calculated by multiplying the number of boluses with the amount of opioid in each bolus in milligrams at the end of 24 h. Following extubation, patients were transferred to the recovery room and mean arterial pressure, VAS score, PCA demand and delivery values, side effects (hypotension, bradycardia, nausea, vomiting, pruritus) and additional analgesic consumption were recorded at 20, 40, 60 min and 2nd, 4th, 6th, 12th and 24th hours by an anaesthesiologist who was blinded to the groups, parallel to previous studies [4][5][6][7]. The patients were asked to rate their satisfaction according to Likert scale (1: Completely comfortable, 2: Very comfortable, 3: Slight discomfort, 4: Painful, 5: Very painful) at the end of 24 h. The patients were also evaluated for a burning sensation and bleeding in the nose.…”

Section: Methodsmentioning

confidence: 99%

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The Efficacy of Submucosal Tramadol in the Postoperative Treatment of Pain Following Septoplasty Operations

Ekmekçi

Beriat

Bengisun

et al. 2012

Indian J Otolaryngol Head Neck Surg

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Tramadol is a centrally acting opioid which is effective for moderate-severe pain and is being used for various acute and chronic pain scenarios. The primary endpoint of this controlled, randomized double blind study was to evaluate the effect of submucosal tramadol on VAS scores after septoplasty operations and secondary endpoint was to investigate the effects on total opioid and additional analgesic consumption and patient satisfaction. 60 patients scheduled for septoplasty under general anaesthesia were enrolled. In Group T, at the end of surgery following hemostasis, 2 mg/kg tramadol was applied as submucosal infiltration to both surgical sites, 2 ml (total 4 ml), by the surgeon. In Group P, at the end of surgery following hemostasis, 2 ml isotonic solution (total 4 ml) was applied as submucosal infiltration to both surgical sites by the surgeon. Total opioid consumption, VAS scores, patient satisfaction was evaluated at the end of 24 h VAS values were higher in Group P on the first and second postoperative hours. Patient controlled analgesia demand and delivery values were higher in Group P on the postoperative 1, 2, 4, 6, 12 and 24th hours. Patient satisfaction was higher and opioid consumption was lower in Group T compared to Group P. There was no difference in additional analgesic consumption between two groups. The results show that patients receiving tramadol had lower VAS scores compared with the placebo groups postoperatively.

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Section: Discussionsupporting

confidence: 50%

Section: Methodsmentioning

confidence: 99%

The Efficacy of Submucosal Tramadol in the Postoperative Treatment of Pain Following Septoplasty Operations

Ekmekçi

Beriat

Bengisun

et al. 2012

Indian J Otolaryngol Head Neck Surg

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“…In papers that tramadol was studied, peroperative i.v. tramadol or peritonsilllary infiltration was shown to be efficient [13,14]. Clinical experience in the use of tramadol reflects mostly paediatric tonsillectomies.…”

Section: Discussionmentioning

confidence: 99%

Preemptive Analgesia with Paracetamol and Tramadol in Pediatric Adenotonsillectomy

Turan¹,

Yüksel²,

Ormanci³

2012

J Anesthe Clinic Res

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“…On the other hand, although this method decreased pain scores in the early postoperative period, it failed to provide any advantage over the intramuscular route regarding analgesic consumption (9). Akkaya et al (10) indicated that, when compared with intravenous administration, peritonsillar tramadol infiltration at the same dose significantly decreased analgesic requirements and side effects, including nausea and vomiting. Although the dose of tramadol for infiltration ranged between 1-2 mg/kg in these studies, we observed the efficiency of a dose of 0.5 mg/kg in our preliminary study and therefore used the minimum effective dose.…”

Section: Vas (Cm)mentioning

confidence: 99%

“…The local anesthetic effect of tramadol has been demonstrated in minor surgical interventions and it has been effectively used for postoperative analgesia (6,7). Peritonsillar tramadol infiltration has been demonstrated to decrease peri-and postoperative analgesic requirements and pain sensation (8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

The Effects of Tramadol and Levobupivacaine Infiltration on Postoperative Analgesia in Functional Endoscopic Sinus Surgery and Septorhinoplasty

Koputan¹,

Apan²,

Öz³

et al. 2012

Balkan Med J

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Objective: The aim of this prospective, randomized, double-blind study was to investigate the postoperative analgesic effects of levobupivacaine or tramadol infiltration administered prior to surgery in septorhinoplasty (SRP) or endoscopic sinus surgery (ESS).Material and Methods: Sixty ASA class I-III adult patients electively undergoing SRP or ESC were included the study. Induction of anesthesia was performed with propofol 2-2.5 mg/kg, rocuronium bromide 0.6 mg/kg and fentanyl 1 μg/kg i.v. Sevoflurane 2% with an N 2 O/O 2 mixture (FiO 2 : 35%) was used for maintenance. Tramadol 0.5 mg/kg (Group T: n=20), levobupivacaine 0.25% (Group L: n=20) and lidocaine 1% (Group C: n=20) in a 1/200,000 adrenaline solution was infiltrated into the surgical area 10 min before the operation (5 mL for ESS and 10 mL for SRP). All patients received fentanyl (bolus dose: 15 μg and lockout interval: 10 min) with a patient-controlled analgesia device during the postoperative period. Pain was assessed using an 11-point visual analogue scale (VAS) every 4 h for the first 24 h. Analgesic requirements, opioid consumption and side effects in the postoperative period were recorded.Results: There was a statistically significant decrease in postoperative fentanyl demand and consumption in patients receiving tramadol. Fentanyl doses in the 24 h period were 345.2±168.8 μg, 221.1±120.6 μg and 184.1±130.3 μg (p=0.002) for the Groups C, L and T, respectively. There were statistically significant differences in fentanyl requirements between the tramadol and control groups at the 16, 20 and 24 h time points (p=0.012, p=0.004 and p=0.002, respectively). The side effect profiles were similar.Conclusions: Our study indicates that the preemptive tramadol infiltration technique is an efficient, practical and safe alternative to levobupivacaine in ESS or SRP operations.

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Comparison of intravenous and peritonsillar infiltration of tramadol for postoperative pain relief in children following adenotonsillectomy

Abstract: In adenotonsillectomy cases, peritonsillar infiltration of tramadol maintains efficient pain relief with lower incidence of nausea and vomiting.

Cited by 33 publications

References 26 publications

The Efficacy of Submucosal Tramadol in the Postoperative Treatment of Pain Following Septoplasty Operations

The Efficacy of Submucosal Tramadol in the Postoperative Treatment of Pain Following Septoplasty Operations

Preemptive Analgesia with Paracetamol and Tramadol in Pediatric Adenotonsillectomy

The Effects of Tramadol and Levobupivacaine Infiltration on Postoperative Analgesia in Functional Endoscopic Sinus Surgery and Septorhinoplasty

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