The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy

Akıncı, Seda Banu; Ayhan, Banu; Aycan, İlker Öngüç; Tirnaksiz, Bulent; Başgül, Elif; Abbasoğlu, Osman; Aypar, Ülkü; Sayek, I

doi:10.1017/s0265021508003694

Cited by 26 publications

(21 citation statements)

References 23 publications

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“…16 Mean systolic BP and RR were lower in group I than in group II at all time intervals but the difference is significant statistically at 0 and 4 hours attributed to better pain control in early postoperative period. As there was no differences in the incidence of adverse effect, so tramadol can be used safely at doses as in our study intraperitoneally, which can be correlated with study done by Akinci et al 13 …”

Section: Discussionsupporting

confidence: 90%

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Can Intraperitoneal Tramadol decrease Pain in Patients undergoing Laparoscopic Cholecystectomy in Postoperative Period? A Randomized Controlled Trial

Jairath¹,

Gupta²,

Singh³

et al. 2017

WJOLS

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Aim:To evaluate analgesic effect of intraperitoneal tramadol in patients undergoing laparoscopic cholecystectomy. Settings and design:Prospective, double blind, randomized study. Materials and methods:Hundred patients undergoing laparoscopic cholecystectomy were randomized into two groups, I and II, of 50 each: Group I received intraperitoneal tramadol 100 mg (diluted in 20 mL of distilled water) immediately after induction of pneumoperitoneum and just before removal of trocars. Similarly, group II received 20 mL of intraperitoneal normal saline. All patients had a standard anesthetic. Rescue analgesia was with diclofenac sodium. Postoperatively, visual analog scale, 1 and 24 hours diclofenac consumption, postoperative hospital course, and adverse effects were recorded. Statistical analysis: Student's t-test and Epi Info statistical software were used for statistical analysis.Results: Pain intensity is significantly less in group I than in group II in first 4 hours, while requirement of analgesic postoperatively is significantly less in group I than in group II in first 8 hours except at 30 and 60 minutes. Better control of blood pressure and respiratory rate was seen in group I in first 4 hours. There was no significant difference between two groups regarding postoperative hospital course and incidence of adverse effect. Conclusion:Intraperitoneally, tramadol provides superior postoperative analgesia in the early postoperative period after laparoscopic cholecystectomy compared with normal saline in patients undergoing laparoscopic cholecystectomy.

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Section: Discussionsupporting

confidence: 90%

“…The sample size has been calculated based on the study, 13 where mean pain score of the normal saline (3.9 ± 2.7) has been consulted. The sample size per group has been calculated to be 50 with 5% level of significance.…”

Section: Methodsmentioning

confidence: 99%

Can Intraperitoneal Tramadol decrease Pain in Patients undergoing Laparoscopic Cholecystectomy in Postoperative Period? A Randomized Controlled Trial

Jairath¹,

Gupta²,

Singh³

et al. 2017

WJOLS

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“…Akinci et al [9] showed that I.V tramadol produced superior post-operative analgesia compared with equivalent dose of Tramadol. On the contrary, Memis et al [10] found that intraperitoneal Tramadol and Bupivacaine are very effective for post-operative analgesia in patients undergoing Laparoscopic tubal ligation.…”

Section: Resultsmentioning

confidence: 99%

Comparison of Efficacy of Intraperitoneally Admin I Stered Local Anaesthetics With Adjuvants for Post - Operative Analgesia After Laparoscopic Cholecystectomy

Subbalakshmi¹,

Satyanarayana²,

B³

2015

jemds

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CONTEXT: Post-operative pain after laparoscopic cholecystectomy is less than open cholecystectomy, but many patients require strong analgesia postoperatively. Intraperitoneal administration of local anaesthetics alone or in combination with various adjuvants can control postoperative pain. AIM: To compare the analgesic effect of the intraperitoneal administration of Bupivacaine, Bupivacaine plus Tramadol and Bupivacaine plus Dexmedetomidine. SETTINGS AND DESIGN: 80 patients undergoing laparoscopic cholecystectomy were randomly allocated to one of four groups: Group C; Group B, Group T and Group D. METHODS AND MATERIAL: 80 patients undergoing laparoscopic cholecystectomy were randomly allocated to one of four groups: Group C received 20 ml of saline; Group B received 20 ml of 0.25% Bupivacaine. Group T received 20 ml of 0.25% Bupivacaine with 100 mg Tramadol and patients allocated to Group D received 20 ml of 0.25% Bupivacaine with 1μg/kg of Dexmedetomidine intraperitoneally post-operatively. Faces pain scale was recorded at 0.5, 1, 2, 4, 6 and 24 hours postoperatively. Time of requirement of rescue analgesia was calculated. Level of sedation postoperatively was assessed. Incidence of postoperative nausea and vomiting (PONV) was also recorded. STATISTICAL ANALYSIS: Data was analyzed by two-way analysis of variance, Student's t-test, Kruscal-Walis and Mann-Whitney U-test. RESULTS: Pain intensity, time of requirement of rescue analgesia, sedation score, as well as PONV were significantly lower in Group D, Group T and Group B than in Group C. Duration of post-operative analgesia was highest with Bupivacaine plus Dexmedetomidine. There were no differences between the three groups receiving Bupivacaine and Bupivacaine with Tramadol and Bupivacaine with Dexmedetomidine in FPS score, incidence of PONV and postoperative analgesic and antiemetic consumption. CONCLUSIONS: Bupivacaine with or without adjuvants provides significant pain relief when administered intraperitoneally after laparoscopic cholecystectomy. Bupivacaine with Dexmedetomidine is superior to plain Bupivacaine or Bupivacaine with Tramadol in providing analgesia for greater duration. No side effects were noticed with instillation of local anaesthetic with or without adjuvants. It significantly reduced the need for antiemetic medication.

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“…Another study by Akinsi et al 25 concluded that intravenous tramadol provides superior postoperative pain relief as compared to intraperitoneal administration.…”

Section: Discussionmentioning

confidence: 99%

Analgesic Efficacy of Intraperitoneal Tramadol vs. Placebo for Postoperative Pain Relief Following Laparoscopic Appendicectomy: A Double Blinded One Year Randomized Control Trial: Single Centric, Hospital Based Study

Pratap¹,

Bellad²

2016

jemds

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CONTEXTEarly postoperative pain is common and predominant complaint which results in prolonged hospital stay. AIMSThe present study explores effectiveness of intraperitoneal instillation of tramadol on postoperative pain relief and emergence of adverse effects following laparoscopic appendectomy. SETTINGS AND DESIGNThe present one year double blinded randomized controlled trial was done in the Department of General Surgery, KLES Dr. Prabhakar Kore Hospital and Medical Research Centre, Belgaum, from January 2014 to December 2014. METHODS AND MATERIALA total of 60 patients undergoing elective laparoscopic appendectomy were enrolled. The selected patients were divided into two groups of 30 each as group A and B based on the drugs that is intraperitoneal tramadol 150 mg (Diluted in 40 mL of normal saline) and 40 mL of intraperitoneal normal saline respectively. STATISTICAL ANALYSIS USEDThe categorical data was expressed as rates, ratios and percentages and comparison was done using Fisher's exact test and chisquare test. Continuous data was expressed as mean±standard deviation and the comparison was done using independent sample 't' test. A probability ('p' value) of less than or equal to 0.05 at 95% confidence interval was considered as statistically significant. RESULTSIn group A, 53.33% of the patients were males compared and 46.67% in group B (p=0.606). The mean age in group A (26.13±9.96 years) and group B (31.43±14.81 years) were comparable (p=0.110). Both the groups were comparable in terms of demographic characteristics, clinical presentation and vitals (p>0.050). The mean VAS scores at beginning were significantly low in group A (1.53±0.94) compared to group B (2.93±1.17) and similar trend was noted at all the durations through the post-operative period (p<0.001). Most of the patients in group A did not request for the post-operative analgesia (56.67% vs 6.67%; p=0.011). In group A, significantly lower numbers of mean doses were administered (0.57±0.82 vs 2.20±0.92; p<0.001). The frequency of postoperative rescue analgesia significantly low in group A at 15 minutes, 30 minutes, 6 hours and 12 hours as compared to group B (p<0.050). Adverse events were noted in 23.33% of the patients with group A compared to 10% in group B (p=0.166). The mean hospital stay in group A was significantly low (p=0.017). CONCLUSIONSIntraperitoneal instillation of tramadol offers effective post-operative visceral pain relief in laparoscopic appendectomy and incidence of adverse effects is well acceptable. KEYWORDSIntraperitoneal Instillation; Laparoscopic Appendectomy; Post-Operative Pain; Tramadol. HOW TO CITE THIS ARTICLE:Pratap V, Bellad AP. Analgesic efficacy of intraperitoneal tramadol vs. placebo for postoperative pain relief following laparoscopic appendicectomy: a double blinded one year randomized control trial: single centric, hospital based study.

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The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy

Abstract: Intravenous tramadol provides superior postoperative analgesia in the early postoperative period after laparoscopic cholecystectomy compared with an equivalent dose of tramadol administered intraperitoneally and with normal saline in patients undergoing laparoscopic cholecystectomy.

Cited by 26 publications

References 23 publications

Can Intraperitoneal Tramadol decrease Pain in Patients undergoing Laparoscopic Cholecystectomy in Postoperative Period? A Randomized Controlled Trial

Can Intraperitoneal Tramadol decrease Pain in Patients undergoing Laparoscopic Cholecystectomy in Postoperative Period? A Randomized Controlled Trial

Comparison of Efficacy of Intraperitoneally Admin I Stered Local Anaesthetics With Adjuvants for Post - Operative Analgesia After Laparoscopic Cholecystectomy

Analgesic Efficacy of Intraperitoneal Tramadol vs. Placebo for Postoperative Pain Relief Following Laparoscopic Appendicectomy: A Double Blinded One Year Randomized Control Trial: Single Centric, Hospital Based Study

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