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Intravenous patient-controlled analgesia after thoracotomy: a comparison of morphine with tramadol

Published online by Cambridge University Press:  02 June 2005

H. Erolçay  and
L. Yüceyar
H. Erolçay
Affiliation:
İstanbul University, Cerrahpaşa Medical Faculty, Department of Anaesthesiology, Istanbul, Turkey
L. Yüceyar
Affiliation:
İstanbul University, Cerrahpaşa Medical Faculty, Department of Anaesthesiology, Istanbul, Turkey
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Abstract

Summary

Background and objective: This study examined the quality of analgesia together with the side-effects produced by tramadol compared with morphine using intravenous patient-controlled analgesia during the first 24 h after thoracotomy.

Methods: Forty-four patients scheduled for thoracotomy were included in the study. Morphine 0.3 mg kg−1 was given interpleurally 20 min before a standard general anaesthetic. In the postanaesthetic care unit, the patients were randomly allocated to one of two groups to self-administer tramadol or morphine using a patient-controlled analgesia device throughout a 24 h period. The patient-controlled analgesia device was programmed to deliver tramadol 20 mg as an intravenous bolus or morphine 2 mg with a lockout time of 10 min.

Results: Mean cumulative morphine and tramadol consumption were 48.13 ± 30.23 and 493.5 ± 191.5 mg, respectively. There was no difference in the quality of analgesia between groups. Five (26.3%) patients in the tramadol group and seven (33%) in the morphine group had nausea, and three of the latter patients vomited. The incidence rate of vomiting with tramadol was 5.2%. All vital signs were within safe ranges. Sedation was less in the tramadol group, but not statistically significant.

Conclusions: In this clinical setting, which includes interpleural morphine pre-emptively, postoperative analgesia provided by tramadol was similar to that of morphine at rest and during deep inspiration. Side-effects were slight and comparable between the patients receiving morphine and tramadol.

Keywords

ANALGESIA, patient-controlledANALGESICS, OPIOID, morphine, tramadolPAIN, postoperativePOSTOPERATIVE COMPLICATIONS, postoperative nausea and vomitingTHORACIC SURGICAL PROCEDURES, thoracotomy
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 20 , Issue 2 , February 2003 , pp. 141 - 146
Copyright
2003 European Society of Anaesthesiology

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