Tramadol or morphine administered during operation: a study of immediate postoperative effects after abdominal hysterectomy

Abstract

Tramadol may cause awareness and EEG activation during anaesthesia. We compared tramadol with morphine, administered during wound-closure, surmising that tramadol may cause earlier awakening, more rapid recovery, less respiratory depression and equivalent pain relief. Forty patients received nitrous oxide-enflurane for abdominal surgery. At wound closure, patients received tramadol 3 mg kg-1 or morphine 0.2 mg kg-1 and end-tidal enflurane concentrations were maintained at 0.5 kPa until skin closure, whereupon anaesthesia was discontinued. Times to spontaneous respiration, awakening and orientation were similar in the two groups, as were blood-gas tensions, ventilatory frequency, pain scores and incidence of nausea. Half of each group required supplementary analgesia during their 90-min stay in the recovery room. P-deletion counts improved more rapidly in the tramadol group. This study confirms previous reports that tramadol did not antagonize the hypnotic effects of volatile anaesthetics. Tramadol, administered during operation, was as effective as morphine in providing postoperative analgesia while permitting more rapid psychomotor recovery.

Wound closure tramadol administration has a short-lived analgesic effect

“…Brennan et al 6 reported that, in animals, early treatment strategies did not necessarily modify later hyperalgesia. In accordance with Brennan's observation, the present study and other studies 5 have demonstrated that there was no evidence that timing of analgesic treatment had an impact on postoperative pain or analgesic requirements.…”

“…Coetzee et al 5 reported that 50% of their patients required supplementary analgesia during their 90-min stay in the recovery room whether they had received 3 mg·kg -1 tramadol or 0.2 mg·kg -1 morphine at wound closure. Brennan et al 6 reported that, in animals, early treatment strategies did not necessarily modify later hyperalgesia.…”

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

“…Several studies have suggested that tramadol infiltration resulted in a longer analgesic time than parenteral tramadol [11,12]. Our study showed that topical administration of 5% tramadol significantly reduced pain scores 21 h after the operation, and at the next week follow-up compared with the control group.…”

Postoperative analgesia with tramadol and indomethacin for diagnostic curettage and early termination of pregnancy

“…9 Coetzee et al suggested that tramadol 3 mg/kg administered during wound closure was as effective as morphine in providing postoperative analgesia after abdominal hysterectomy. 10 The tramadol dose and timing of administration used in our study was based on a pilot study of minor gynecological procedures and the pharmacokinetics of tramadol, respectively. The analgesic efficacy of rectal tramadol was compared to indomethacin, which is used extensively following minor gynecological procedures, but has adverse effects such as nausea, vomiting, dry mouth, headache, dizziness, gastrointestinal discomfort and bleeding, impaired renal function and bronchospasm.…”