Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-18T13:49:58.589Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of tramadol versus meperidine for pain relief and safe recovery after adenotonsillectomy

Published online by Cambridge University Press:  11 July 2005

Z. Özer ,
K. Görür ,
A. A. Altunkan ,
E. Bilgin ,
H. Çamdeviren  and
U. Oral
Z. Özer
Affiliation:
Mersin University Medical Faculty, Department of Anaesthesiology and Reanimation, Mersin, Turkey
K. Görür
Affiliation:
Mersin University Medical Faculty, Department of Otorhinolaryngology, Mersin, Turkey
A. A. Altunkan
Affiliation:
Mersin University Medical Faculty, Department of Anaesthesiology and Reanimation, Mersin, Turkey
E. Bilgin
Affiliation:
Mersin University Medical Faculty, Department of Anaesthesiology and Reanimation, Mersin, Turkey
H. Çamdeviren
Affiliation:
Mersin University Medical Faculty, Department of Biostatistics, Mersin, Turkey
U. Oral
Affiliation:
Mersin University Medical Faculty, Department of Anaesthesiology and Reanimation, Mersin, Turkey
Get access

Abstract

Summary

Background and objective: Adequate relief of pain after tonsillectomy is a common problem. We compared meperidine and tramadol when given at induction of anaesthesia with respect to their effects on postoperative pain relief and emergence characteristics after adenotonsillectomy in children.

Methods: Fifty children aged 4–7 yr undergoing tonsillectomy were randomly assigned to receive either tramadol 1 mg kg−1 (n = 25) or meperidine 1 mg kg−1 (n = 25) before commencement of the surgical procedure. Anaesthesia was induced with propofol (with cis-atracurium for muscle relaxation) and maintained with sevoflurane in oxygen and nitrous oxide. Postoperative pain was scored by a blinded observer using a facial pain scale in the recovery room at 0 (at arrival of the patient in the postoperative care unit) and at 10, 20 and 45 min thereafter. Agitation scores were also assessed by the same observer at 0 min. Heart rate and mean arterial pressure were recorded at regular intervals. The time to recovery to spontaneous respiration and the incidence of postoperative nausea and vomiting were noted.

Results: Facial pain scale scores were increased in the tramadol group at 0, 10 and 20 min (P < 0.05). No difference was observed in scores at the 45th min postoperation. Agitation scores were higher in the tramadol group than in the meperidine group. No statistical difference was found between the two groups. Heart rates and mean arterial pressures were similar in both groups. The time to recovery to spontaneous respiration was delayed with meperidine compared with tramadol (P < 0.05). The incidence of nausea and vomiting was not statistically different between groups.

Conclusions: Meperidine was more effective for pain relief and provides better emergence characteristics than tramadol after tonsillectomy in children.

Keywords

CYCLOHEXANOLS, tramadolISONIPECOTIC ACIDS, meperidineOTORHINOLARYNGOLOGICAL SURGICAL PROCEDURES, tonsillectomyPAEDIATRICSPAIN, postoperative
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 11 , November 2003 , pp. 920 - 924
Copyright
2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Wilson JT, Murray A, MacKenzie K. Prospective study of morbidity after tonsillectomy in children. Int J Pediatr Otorhinolaryngol 2001; 58: 119–125.Google Scholar
Caumo W, Broenstrub JC, Fialho L, et al. Risk factors for postoperative anxiety in children. Acta Anaesthesiol Scand 2000; 44: 782–789.Google Scholar
Van den Berg AA, Montoya-Pelaez LF, Halliday EM, Hassan I, Baloch MS. Analgesia for adenotonsillectomy in children and young adults: a comparison of tramadol, meperidine and nalbuphine. Eur J Anaesthesiol 1999; 16: 186–194.Google Scholar
Ho John WS, Khambatta HJ, Pang LM, Siegfried RN, Sun LS. Preemptive analgesia in children. Reg Anesth 1997; 22: 125–130.Google Scholar
Bamigbade TA, Langford RM. The clinical use of tramadol hydrochloride. Pain Reviews 1998; 5: 155–182.Google Scholar
Naguib M, Seraj M, Attia M, Samarkandi AH, Seet M, Jaroudi R. Perioperative antinociceptive effects of tramadol. A prospective, randomized, double blind comparison with morphine. Can J Anaesth 1998; 45: 1168–1175.Google Scholar
Davis PJ, Cohen IT, McGowan FX, Latta K. Recovery characteristics of desflurane versus halothane for maintenance of anesthesia in pediatric ambulatory patients. Anesthesiology 1994: 80: 298–302.Google Scholar
Bieri D, Reeve R, Champion GD, Addicoat L, Ziegler JB. The faces pain scale for self assessment of the severity of pain experienced by children. Pain 1990; 41: 139–150.Google Scholar
Perry F, Parker RK, White PF, Clifford A. Role of psychological factors in postoperative pain control and recovery with patient-controlled analgesia. Clin J Pain 1994; 10: 57–63.Google Scholar
Gil KM, Ginsberg B, Muir M, Sykes D, Williams DA. Patient controlled analgesia in postoperative pain: the relation of psychological factors to pain and analgesic use. Clin J Pain 1990; 6: 137–142.Google Scholar
Jamison RN, Taft K, O'Hara JP, Ferrante FM. Psychosocial and pharmacological predictors of satisfaction with intravenous patient-controlled analgesia. Anesth Analg 1993; 77: 121–125.Google Scholar
Grundmann U, Uth M, Eichner A, Wilhelm W, Larsen R. Total intravenous anesthesia with propofol and remifentanil in pediatric patients: a comparison with a desflurane–nitrous oxide inhalation anesthesia. Acta Anaesthesiol Scand 1998; 42: 845–850.Google Scholar
Özköse Z, Akçabay M, Kemaloğglu YK, Sezenler S. Relief of posttonsillectomy pain with low dose tramadol given at induction of anesthesia in children. Int J Ped Otorhinolaryngol 2000; 53: 207–214.Google Scholar
Pinsker CM, Carrol NV. Quality of emergence from anesthesia and incidence of vomiting with remifentanil in a pediatric population. Anesth Analg 1999; 89: 71–74.Google Scholar
Larsen B, Seitz A, Larsen R. Recovery of cognitive function after remifentanil–propofol anesthesia: a comparison with desflurane and sevoflurane anesthesia. Anesth Analg 2000; 90: 168–174.Google Scholar
Picard V, Dumont L, Pellegrini M. Quality of recovery in children: sevoflurane versus propofol. Acta Anaesthesiol Scand 2000; 44: 307–310.Google Scholar
Houmes RM, Voets MA, Verkaaik A, Erdman W, Lachmann B. Efficacy and safety of tramadol versus morphine for moderate and severe postoperative pain with special regard to respiratory depression. Anesth Analg 1992; 74: 510–514.Google Scholar
Vickers MD, O'Flaherty D, Szekely SM, Read M, Yoshizumi J. Tramadol: pain relief by an opioid without depression of respiration. Anaesthesia 1992; 47: 291–296.Google Scholar
Courtney MJ, Cabraal D. Tramadol vs diclofenac for posttonsillectomy analgesia. Arch Otolaryngol Head Neck Surg 2001; 127: 385–388.Google Scholar