Comparison of the effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post-tonsillectomy pain

Hatami, Maryam; Jalali, M J; Ayatollahi, Vida; Baradaranfar, Mohammad Hossein; Vaziribozorg, Sedighe

doi:10.1007/s00405-021-07102-y

Cited by 5 publications

(4 citation statements)

References 14 publications

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“…Data from the included studies were extracted using standardized forms and independently examined by the 2 authors (YJK, SHH). The evaluated outcomes were postoperative pain from just arrival of post-anesthesia care unit to 24 hours 8,12,[15][16][17][18][19][20][21][22][23][24][25][26][27][28] the time to take the first analgesic, 12,15,16,20,21,26,27,29 and the occurrence of postoperative nausea and vomiting (incidence or percentage of patients). 12,16,19,20,22,25,[27][28][29] The outcomes were compared with respect to the other treatment strategies and the control groups.…”

Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

“…5 The efficacy of ropivacaine, bupivacaine, levobupivacaine, ketamine, tramadol, dexamethasone, and other local anesthetic drugs administered locally to the tonsillar fossa to relieve postoperative pain after pediatric adenotonsillectomy have been studied. [5][6][7][8] Recently, the use of adjuvants for local drug infiltration to enhance the effects of local nerve blocking has been studied. 7,[9][10][11] Tramadol is a μ-receptor-acting anesthetic drug with faster patient recovery and less respiratory depression.…”

Section: Introductionmentioning

confidence: 99%

“…7,[9][10][11] Tramadol is a μ-receptor-acting anesthetic drug with faster patient recovery and less respiratory depression. 8 It is a long-acting drug and has both central and local action. 12,13 Peritonsillar applied tramadol for postoperative pain relief has been researched in many studies, but no previous meta-analyses have compared tramadol with placebo or other topical agents.…”

Section: Introductionmentioning

confidence: 99%

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The analgesic Efficacy and Safety of Topically Applied Tramadol in Peritonsillar Space During Pediatric Adenotonsillectomy: A Meta-Analysis

Kang

Cho

Hwang

2022

Ann Otol Rhinol Laryngol

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Objectives: To evaluate the efficacy of topically applied tramadol in peritonsillar area for pain control and induction of perioperative morbidity in children undergoing adenotonsillectomy. Methods: Two authors independently searched the databases (MEDLINE, SCOPUS, and Cochrane databases) up to April 2022 for randomized controlled trials comparing the efficacy of an intraoperative peritonsillar administered tramadol with placebo or other agents only in pediatric patients. The outcomes were postoperative pain scores, time to take the first pain reducing drugs, and postoperative nausea/vomiting. Results: Our analysis was based on 17 trials. Peritonsillar administered tramadol significantly reduced postoperative pain at less than 20 minutes (SMD −1.5852, 95% CI [−2.3900; −0.7804]), 1 hour (SMD −1.5811, 95% CI [−2.3400; −0.8222]), 8 hours (SMD −1.0258, 95% CI [−1.8792; −0.1724]), 16 hours (SMD −0.8397, 95% CI [−1.4266; −0.2529]), and 1 day (SMD −1.0110, 95% CI [−1.5213; −0.5007]) and the time to take the first analgesic drug (SMD 1.6565, 95% CI [0.2838; 3.0293]) compared with the placebo. However, tramadol showed no significant difference on postoperative pain relief effects and the time to take the first analgesic drug compared to the other topical agents (bupivacaine, lidocaine, ketamine, and dexamethasone). Tramadol did not cause significant postoperative nausea and vomiting. Conclusions: This study demonstrated that intraoperatively applied topical tramadol could control postoperative pain and reduce the analgesic uptake compared with a control. However, the efficacy of tramadol in pain control was similar to other agents in pediatric adenotonsillectomy.

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Section: Data Extraction and Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The analgesic Efficacy and Safety of Topically Applied Tramadol in Peritonsillar Space During Pediatric Adenotonsillectomy: A Meta-Analysis

Kang

Cho

Hwang

2022

Ann Otol Rhinol Laryngol

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“…[ 2 ] Inadequate pain control leads to decreased oral intake, which results in dehydration, readmission for pain control, extended hospital stays, and increased cost, and the continued pathologic responses to pain may lead to chronic pain in adulthood. [ 3 ] Managing acute postoperative pain is a major challenge for practitioners, given that more than 80% of patients report pain after surgery, and 75% report the pain as moderate, severe, or even extreme. [ 4 ] Ketamine and tramadol have been found to have local anesthetic properties.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the effects of peritonsillar infiltration of tramadol–ketamine combination versus tramadol alone on posttonsillectomy pain in children

Nuhu,

Atteh,

Embu

et al. 2023

J West Afr Coll Surg

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Introduction: Tonsillectomy is associated with significant pain and post-operative pain control is often unsatisfactory. This study sought to evaluate the effect of peritonsillar infiltration of tramadol–ketamine combination, tramadol alone and ketamine alone on post-tonsillectomy pain in children. Patients and Methods: A randomized double-blinded interventional study involving 90 patients aged 3-15 years of American society of anesthesiologists I or II physical status scheduled for elective adenoidectomy, tonsillectomy or adenotonsillectomy at JUTH was conducted. Patients were randomized into one of three groups: group I received tramadol 2mg/kg, group II received ketamine 1mg/kg plus tramadol 2mg/kg and group III received ketamine 1mg/kg only all made up to 2mls with normal saline and 1ml given per tonsillar bed. All patients had standard general anaesthesia with endotracheal intubation and monitoring. Data was analyzed using Epi-info version 7.1.5 with p £ 0.05. Result: The analysis of data showed that the mean ages of the participants in group I, II and III were 5.70±2.00, 5.69±3.22 and 4.47±2.01 years respectively (p-value=0.091). Group II had significantly lower pain scores, longer time to first request of analgesia, earlier oral intake and discharge from the hospital compared to the group that received either tramadol or ketamine alone. Minimal side effects were noted across all the groups in the study. Conclusion: Peri-tonsillar infiltration of tramadol-ketamine combination immediately after tonsillectomy (but before extubation of patients) significantly decreased post-tonsillectomy pain without increasing the incidence of side effects compared to tramadol or ketamine alone in children undergoing adenotonsillectomy.

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The effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post‑tonsillectomy pain

Luo

Huang

2022

Eur Arch Otorhinolaryngol

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Comparison of the effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post-tonsillectomy pain

Cited by 5 publications

References 14 publications

The analgesic Efficacy and Safety of Topically Applied Tramadol in Peritonsillar Space During Pediatric Adenotonsillectomy: A Meta-Analysis

The analgesic Efficacy and Safety of Topically Applied Tramadol in Peritonsillar Space During Pediatric Adenotonsillectomy: A Meta-Analysis

Evaluation of the effects of peritonsillar infiltration of tramadol–ketamine combination versus tramadol alone on posttonsillectomy pain in children

The effect of peritonsillar infiltration of tramadol vs dexmedetomidine on post‑tonsillectomy pain

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