Comparing the Effect of Subcutaneous and Intravenous Tramadol Injection on Postoperative Pain

Document Type : Original Article(s)

Authors

1 Assistant Professor, Department of Anesthesiology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran.

2 Student of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Recently it is suggested that local injection of tramadol can reduce postoperative pain; but it is controversial whether the intravenous injection is more perfect or subcutaneous. We conducted this study to compare the effect of these methods on postoperative pain.Methods: In a prospective randomized double blind clinical trial study, 75 patients undergoing abdominal surgery were allocated in three groups (n = 25). In group A (subcutaneous), 1.5 mg/kg tramadol was injected subcutaneously and normal saline was injected intravenous in an equal volume of 10 cc; in group B (intravenous) 1.5 mg/kg tramadol was injected intravenous and normal saline was injected subcutaneously in an equal volume of 10 cc;and in group C (control) normal saline was injected subcutaneously and intravenous in an volume of 10 cc. The drugs were injected before incision of surgery in all groups. The severity of postoperative pain after surgery was evaluated by visual analogue scale and the time of first opioid analgesic used and total analgesic dose taken during the postoperative period was recorded.Finding: The total dose of used opioid analgesic was significantly less in subcutaneously injected tramadol group (P < 0.01). The time of the first opioid analgesic consumption was significantly shorter in control group (P < 0.01).Conclusion: According to results of this study, subcutaneous and intravenous injection of tramadol can reduce postoperative pain; subcutaneous injection was more effective, of course. Therefore, subcutaneous tramadol is suggested for control of postoperative pain.

Keywords

References

  1. Wu CL, Robert WH. Acute Postoperative Pain. In: Miller R, Miller's Anesthesia. Churchill Livingstone; 2005: 2729-37.
  2. James MF, Heijke SA, Gordon PC. Intravenous tramadol versus epidural morphine for postthoracotomy pain relief: a placebo-controlled double-blind trial. Anesth Analg 1996; 83(1): 87-91.
  3. Altunkaya H, Ozer Y, Kargi E, Ozkocak I, Hosnuter M, Demirel CB, et al. The postoperative analgesic effect of tramadol when used as subcutaneous local anesthetic. Anesth Analg 2004; 99(5): 1461-4.
  4. Hopkins D, Shipton EA, Potgieter D, Van derMerwe CA, Boon J, De Wet C, et al. Comparison of tramadol and morphine via subcutaneous PCA following major orthopaedic surgery. Can J Anaesth 1998; 45(5 Pt 1): 435-42.
  5. Pang WW, Mok MS, Chang DP, Yang TF, Lin CH, Huang MH. Intradermal injection of tramadol has local anesthetic effect: a comparison with lidocaine. Acta Anaesthesiol Sin 1998; 36(3): 133-6.
  6. Pang WW, Mok MS, Chang DP, Huang MH. Local anesthetic effect of tramadol, metoclopramide, and lidocaine following intradermal injection. Reg Anesth Pain Med 1998; 23(6): 580-3.
  7. Acalovschi I, Cristea T, Margarit S, Gavrus R. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg 2001; 92(1): 209-14.
  8. Wong WH, Cheong KF. Role of tramadol in reducing pain on propofol injection. Singapore Med J 2001; 42(5): 193-5.
  9. Gercek A, Eti Z, Gogus FY, Sav A. The analgesic and anti-inflammatory effects of subcutaneous bupivacaine, morphine and tramadol in rats. Agri 2004; 16(3): 53-8.
  10. Langlois G, Estebe JP, Gentili ME, Kerdiles L, Mouilleron P, Ecoffey C. The addition of tramadol to lidocaine does not reduce tourniquet and postoperative pain during IV regional anesthesia. Can J Anaesth 2002; 49(2): 165-8.
Journal of Isfahan Medical School
Volume 28, Issue 113 - Serial Number 113
September and October 2011
Pages 745-751

Files

History

  • Receive Date: 02 March 2011
  • Revise Date: 06 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics