Post-operative pain control after tonsillectomy: dexametasone vs tramadol

Topal, Kübra; Aktan, Bülent; Sakat, Muhammed Sedat; Kılıç, Korhan; Gözeler, Mustafa Sıtkı

doi:10.1080/00016489.2016.1269945

Cited by 13 publications

(17 citation statements)

References 17 publications

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“…Seven of them were considered inappropriate for inclusion in the final analysis due to methodological constraints or non‐English full‐text publication. The selected articles consisted of 12 RCTs enrolling a total of 972 children, among which 345 were assigned to the tramadol peritonsillar infiltration group and the remaining 627 in the placebo or active comparator groups. All of these studies met the criteria to be included in the final qualitative appraisal, whilst 8 RCTs incorporating both a comparison to the placebo group and tramadol dosing of 2 mg/kg were deemed eligible to be included in the quantitative analysis .…”

Section: Resultsmentioning

confidence: 99%

“…The majority of the included RCTs implemented a 3‐arm study design, whilst 2 or 4 comparison groups were incorporated in 4 and 3 RCTs, respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Peritonsillar infiltration of tramadol was compared either to placebo and/or to an active comparator, namely ketamine, lidocaine, bupivacaine, dexamethasone, or tramadol administered via an alternative route . It should be noted that 2 studies defined the use of a racemic mixture of ketamine, whilst no relevant report was made by the authors of the remaining three RCTs …”

Section: Resultsmentioning

confidence: 99%

“…Pre‐incisional application of local infiltration of tramadol was adopted by the majority of study designs, with the exception of 3 RCTs implementing this practice after tonsillectomy conclusion . Standard dosing of tramadol (2 mg/kg) was recorded in all included studies but one, which applied 0.1 mg/kg of tramadol for local infiltration …”

Section: Resultsmentioning

confidence: 99%

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Analgesic Efficacy and Safety of Local Infiltration of Tramadol in Pediatric Tonsillectomy Pain: A Systematic Review and Meta‐Analysis

et al. 2020

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Objectives The aim of this systematic review and meta‐analysis was to appraise clinical evidence of the impact of peritonsillar infiltration of tramadol, on postoperative pain control and the occurrence of adverse effects in children undergoing tonsillectomy. Methods A database search was conducted to identify randomized controlled trials (RCTs) pertinent to peritonsillar infiltration of tramadol compared to no treatment (placebo) or other analgesic regimens. The outcomes of interest were postoperative pain intensity, time to first analgesic demand, rescue analgesic consumption up to 24 hours after intervention, and the occurrence of adverse events. Results Twelve RCTs enrolling 972 pediatric patients were selected for qualitative analysis, among which eight were suitable for meta‐analysis. Tramadol infiltration induced a significant reduction of pain intensity up to 24 hours post‐tonsillectomy (mean difference [MD], −2.31; 95% confidence interval [CI], −3.49 to −1.12; P < 0.001; I2 = 97%) and time to first analgesic (MD 180.54; 95% CI, 56.91 to 304.18; P = 0.004; I2 = 99%), with no profound impact on postoperative nausea and vomiting (risk ratio [RR] 0.98; 95% CI, 0.73 to 1.32; P = 0.90; I2 = 0%) compared to the placebo group. The analgesic efficacy of tramadol infiltration was equivalent to the local or systematic use of ketamine or infiltration with local anesthetics. This effect was further enhanced when tramadol infiltration served as an adjunct to other analgesic interventions. No serious adverse events were reported. Conclusions In children undergoing tonsillectomy, peritonsillar infiltration of tramadol is associated with a postoperative analgesic benefit when compared to placebo, with negligible adverse events. Yet, no definite conclusion can be drawn due to the low quality, considerable heterogeneity, and paucity of the available data.

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Section: Resultsmentioning

confidence: 99%

“…The majority of the included RCTs implemented a 3‐arm study design, whilst 2 or 4 comparison groups were incorporated in 4 and 3 RCTs, respectively.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Analgesic Efficacy and Safety of Local Infiltration of Tramadol in Pediatric Tonsillectomy Pain: A Systematic Review and Meta‐Analysis

et al. 2020

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“…Three studies [8,16,18] reported that dexamethasone was administered by local infiltration. The result showed that dexamethasone was favoured for preventing PONV (RR 0.58, 95% CI 0.341-0.99, I 2 =0%; Figure 4).…”

Section: Dexamethasone Local Infiltrationmentioning

confidence: 99%

Dexamethasone for the prevention of postoperative nausea and vomiting in children undergoing non-cardiac surgery: a systematic review and meta-analysis

Shen

Li²,

Zhou

et al. 2019

Preprint

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BACKGROUND: Postoperative nausea and vomiting (PONV) is a frequent and distressing complication of general anaesthesia in paediatric patients. Dexamethasone was reported to prevent PONV in previous randomized controlled trials (RCTs). The purpose of this meta-analysis was to evaluate the role of dexamethasone in the prevention of PONV in children undergoing non-cardiac surgery. METHODS: PubMed, EMBASE, the Cochrane Library, and Web of Science were searched to identify randomized trials that reported the efﬁcacy of perioperative dexamethasone in paediatric non-cardiac surgical patients. RESULTS: Fourteen randomized controlled trials that included 1700 children were included. Compared with placebo, dexamethasone showed a lower incidence of PONV by intravenous injection (RR 0.38, 95% confidence interval (CI) 0.30–0.49) and by local infiltration (RR 0.58, 95% CI 0.34–0.99). The combination of dexamethasone and a 5-HT3 receptor antagonist was more effective than the 5-HT3 antagonist or dexamethasone alone in preventing PONV. CONCLUSION: Perioperative dexamethasone was an effective measure with few complications for preventing PONV in children after non-cardiac surgery.

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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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Post-operative pain control after tonsillectomy: dexametasone vs tramadol

Cited by 13 publications

References 17 publications

Analgesic Efficacy and Safety of Local Infiltration of Tramadol in Pediatric Tonsillectomy Pain: A Systematic Review and Meta‐Analysis

Analgesic Efficacy and Safety of Local Infiltration of Tramadol in Pediatric Tonsillectomy Pain: A Systematic Review and Meta‐Analysis

Dexamethasone for the prevention of postoperative nausea and vomiting in children undergoing non-cardiac surgery: a systematic review and meta-analysis

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

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