Authors
Department of Anesthesiology, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
Background: Recently, the preemptive analgesic effects of subcutaneous infiltration of tramadol (T) in the site of incision have not been extensively studied. In this study, we investigated the effect of subcutaneous T infiltration before the incision of surgery on post-operative pain, in lower abdomen surgeries.
Materials and Methods: This double-blind study was carried out on 90 patients (18-65 years) of American Society Anesthesiologists physical status I and II who were candidates for a lower abdomen surgery during 2011. They were randomly assigned to receive preemptive subcutaneous T or normal saline (NS). The visual analogue scale for pain (VAS) in rest and cough position and opium total dose consumption were compared between two groups in times 0, 15, 30, 60 min and 2, 4, 6, 12, 24 h after the surgery.
Results: The VAS in cough and rest position in the first 24 h following the surgery was lower in group T ( P < 0.05). Opium consumption was lower in group T ( P < 0.05).
Conclusion: Subcutaneous preemptive infiltration of T before surgical incision reduces post-operative opioid consumption.
Keywords
1. | Ng A, Parker J, Toogood L, Cotton BR, Smith G. Does the opioid-sparing effect of rectal diclofenac following total abdominal hysterectomy benefit the patient? Br J Anaesth 2002;88:714-6. |
2. | Benyamin R, Trescot AM, Datta S, Buenaventura R, Adlaka R, Sehgal N, et al. Opioid complications and side effects. Pain Physician 2008;11:S105-20. [PUBMED] |
3. | Koduli B, Obeoi J. Management of postoperative pain in obstetrics and gynecology, 2009. Available from: http://www.uptodate.com/. [Last cited 2008 Apr 01]. |
4. | Brower MC, Johnson ME. Adverse effects of local anesthetic infiltration on wound healing. Reg Anesth Pain Med 2003;28:233-40. [PUBMED] |
5. | Scott LJ, Perry CM. Tramadol: A review of its use in perioperative pain. Drugs 2000;60:139-76. [PUBMED] |
6. | Grond S, Sablotzki A. Clinical pharmacology of tramadol. Clin Pharmacokinet 2004;43:879-923. [PUBMED] |
7. | Desmeules JA, Piguet V, Collart L, Dayer P. Contribution of monoaminergic modulation to the analgesic effect of tramadol. Br J Clin Pharmacol 1996;41:7-12. [PUBMED] |
8. | Mert T, Gunes Y, Guven M, Gunay I, Ozcengiz D. Comparison of nerve conduction blocks by an opioid and a local anesthetic. Eur J Pharmacol 2002;439:77-81. [PUBMED] |
9. | Altunkaya H, Ozer Y, Kargi E, Babuccu O. Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures. Br J Anaesth 2003;90:320-2. [PUBMED] |
10. | Khajavi MR, Aghili SB, Moharari RS, Najafi A, Mohtaram R, Khashayar P, et al. Subcutaneous tramadol infiltration at the wound site versus intravenous administration after pyelolithotomy. Ann Pharmacother 2009;43:430-5. [PUBMED] |
11. | Immer FF, Immer-Bansi AS, Trachsel N, Berdat PA, Eigenmann V, Curatolo M, et al. Pain treatment with a COX-2 inhibitor after coronary artery bypass operation: A randomized trial. Ann Thorac Surg 2003;75:490-5. [PUBMED] |
12. | Lowenstein L, Zimmer EZ, Deutsch M, Paz Y, Yaniv D, Jakobi P. Preoperative analgesia with local lidocaine infiltration for abdominal hysterectomy pain management. Eur J Obstet Gynecol Reprod Biol 2008;136:239-42. [PUBMED] |
13. | Møiniche S, Kehlet H, Dahl JB. A qualitative and quantitative systematic review of preemptive analgesia for postoperative pain relief: The role of timing of analgesia. Anesthesiology 2002;96:725-41. |
14. | Kaufman E, Epstein JB, Gorsky M, Jackson DL, Kadari A. Preemptive analgesia and local anesthesia as a supplement to general anesthesia: A review. AnesthProg 2005;52:29-38. |
15. | Crile GW. The kinetic theory of shock and its prevention through anoci-association. Lancet 1913;185:7-16. |
16. | Pang WW, Huang PY, Chang DP, Huang MH. The peripheral analgesic effect of tramadol in reducing propofol injection pain: A comparison with lidocaine. Reg Anesth Pain Med 1999;24:246-9. |
17. | Tsai YC, Chang PJ, Jou IM. Direct tramadol application on sciatic nerve inhibits spinal somatosensory evoked potentials in rats. Anesth Analg 2001;92:1547-51. [PUBMED] |
18. | Kapral S, Gollmann G, Waltl B, Likar R, Sladen RN, Weinstabl C, et al. Tramadol added to mepivacaine prolongs the duration of an axillary brachial plexus blockade. Anesth Analg 1999;88:853-6. [PUBMED] |
19. | Ozyilmaz K, Ayoglu H, Okyay RD, Yurtlu S, Koksal B, Hanci V, et al. Postoperative analgesic effects of wound infiltration with tramadol and levobupivacaine in lumbar disk surgeries. J Neurosurg Anesthesiol 2012;24:331-5. [PUBMED] |
20. | Isiordia-Espinoza MA, Pozos-Guillén AJ, Martínez-Rider R, Herrera-Abarca JE, Pérez-Urizar J. Preemptive analgesic effectiveness of oral ketorolac plus local tramadol after impacted mandibular third molar surgery. Med Oral Patol Oral Cir Bucal 2011;16:e776-80. |
21. | Unlugenc H, Ozalevli M, Gunes Y, Guler T, Isik G. Pre-emptive analgesic efficacy of tramadol compared with morphine after major abdominal surgery. Br J Anaesth 2003;91:209-13. [PUBMED] |
22. | dos Santos TO, Estrela TG, de Azevedo VL, de Oliveira OE, Oliveira G Jr, Figueiredo Gda S. Intravenous and subcutaneous tramadol for inguinal herniorrhaphy: Comparative study. Rev Bras Anestesiol 2010;60:522-7. [PUBMED] |
23. | Hassan SS, Ahmed A, Rai M, Kalappa T. Analgesic efficacy of tramadol and butorphanol in mandibular third molar surgery: A comparative study. J Contemp Dent Pract 2012;13:364-70. |
24. | Da Costa Araújo FA, de Santana Santos T, de Morais HH, LaureanoFilho JR, de Oliveira E Silva ED, Vasconcellos RJ.Comparative analysis of preemptive analgesic effect of tramadol chlorhydrate and nimesulide following third molar surgery. J Craniomaxillofac Surg 2012;40:e346-9. |
25. | Demiraran Y, Ilce Z, Kocaman B, Bozkurt P. Does tramadol wound infiltration offer an advantage over bupivacaine for postoperative analgesia in children following herniotomy? PaediatrAnaesth 2006;16:1047-50. |
26. | Shipton EA. Tramadol-present and future. Anaesth Intensive Care 2000;28:363-74. [PUBMED] |
27. | Acalovschi I, Cristea T, Margarit S, Gavrus R. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg 2001;92:209-14. [PUBMED] |