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Comparison of peritonsillar infiltration of tramadol and lidocaine for the relief of post-tonsillectomy pain

Published online by Cambridge University Press:  19 September 2012

M H Heiba ,
A Atef ,
M Mosleh ,
R Mohamed  and
M El-Hamamsy
M H Heiba
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
A Atef*
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
M Mosleh
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
R Mohamed
Affiliation:
Department of Otorhinolaryngology, Faculty of Medicine, Cairo University, Egypt
M El-Hamamsy
Affiliation:
Department of Anesthesia, Faculty of Medicine, El-Fayoum University, Egypt
*
Address for correspondence: Dr A Atef, 7 Mahmoud Afifi St, Almaza, Cairo, Egypt 11341 E-mail: [email protected]
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Abstract

Background:

Several studies have reported the use of peritonsillar infiltrations of local anaesthetics and/or locally active analgesic drugs for the relief of post-tonsillectomy pain, with variable results in terms of quality and duration of analgesia. We aimed to compare the effects of peritonsillar infiltration of lidocaine versus tramadol versus placebo on post-tonsillectomy pain.

Methods:

Sixty patients over the age of 10 years undergoing bilateral elective tonsillectomy under general anaesthesia were randomised into three groups. The first group received peritonsillar infiltration of tramadol, the second 2 per cent lidocaine and the third normal saline. In all groups, peritonsillar infiltration was carried out after tonsillectomy but prior to tracheal extubation. Post-operative comparisons were made to assess the quality of pain control and the patients' analgesic requirements.

Results:

Peritonsillar infiltration of tramadol provided an analgesic effect comparable to that of lidocaine in the first 6 hours post-operation, as reflected by visual analogue scale pain scores and opioid requirements, which were lower compared with the placebo group.

Conclusion:

Peritonsillar infiltration of tramadol provided pain control in the first 6 hours post-tonsillectomy which was comparable to that of lidocaine.

Keywords

TonsillectomyPostoperative PainLidocaineTramadol
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 11 , November 2012 , pp. 1138 - 1141
Copyright
Copyright © JLO (1984) Limited 2012

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References

1 Catlin, FI, Grimes, WJ. The effect of steroid therapy on recovery from tonsillectomy in children. Arch Otolaryngol Head Neck Surg 1991;117:649–52CrossRefGoogle Scholar
2 Courtney, MJ, Cabraal, D. Tramadol vs. diclofenac for post-tonsillectomy analgesia. Arch Otolaryngol Head Neck Surg 2001;127:385–8CrossRefGoogle Scholar
3 Ozkose, Z, Akcabay, M, Kemaloglu, YK, Sezenler, S. Relief of post-tonsillectomy pain with low dose tramadol given at induction of anesthesia in children. Int J Pediatr Otorhinolaryngol 2000;53:207–14CrossRefGoogle Scholar
4 Pappas, AL, Sukhani, R, Bowie, JR. Post-tonsillectomy analgesia and recovery: narcotics versus local anesthetics. Anesthesiology 1989;71:694CrossRefGoogle Scholar
5 Hope, JW, Taylor, GW, Pendergrass, EP, Schenck, HP. Effects of irradiation on post-tonsillectomy pain. Am J Roentgenol Radium Ther Nucl Med 1954;71:251–2Google ScholarPubMed
6 Bissonnette, B. Lidocaine aerosol following tonsillectomy in children. Can J Anaesth 1990;37:534–7CrossRefGoogle ScholarPubMed
7 Bamigbade, TA, Davidson, C, Langford, RM, Stamford, JA. Action of tramadol, its enantiomers and principal, O-desmethyltramadol, on serotonin (5-HT) efflux and uptake in the rat dorsal raphe nucleus. Br J Anaesth 1997;79:352–6CrossRefGoogle ScholarPubMed
8 Jou, IM, Chu, KS, Chen, HH, Chang, PJ, Tsai, YC. The effects of intrathecal tramadol on spinal somatosensory-evoked potentials and motor evoked responses in rats. Anesth Analg 2003;96:783–8CrossRefGoogle ScholarPubMed
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;90:320–2CrossRefGoogle ScholarPubMed
10 Atef, A, Fawaz, AA. Peritonsillar infiltration with tramadol improves pediatric tonsillectomy pain. Eur Arch Otorhinolaryngol 2008;265:571–4CrossRefGoogle ScholarPubMed
11 Chapman, CR, Casey, KL, Dubner, R, Foley, KM, Gracely, RH, Reading, AE. Pain measurement: an overview. Pain 1985;22:1–31 CrossRefGoogle ScholarPubMed
12 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;99:1461–4CrossRefGoogle ScholarPubMed
13 Wagner, LE 2nd, Eaton, M, Sabnis, SS, Gingrich, KJ. Meperidine and lidocaine block of recombinant voltage-dependent Na+ channels: evidence that meperidine is a local anesthetic. Anesthesiology 1999;91:1481–90CrossRefGoogle ScholarPubMed
14 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 CrossRefGoogle Scholar
15 Akbay, BK, Yilizbas, S, Guclu, E, Yilaz, S, Iskender, A, Ozturk, O. Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy. J Anesth 2010;24:705–8CrossRefGoogle ScholarPubMed
16 Ugur, MB, Yilmaz, M, Altunkaya, H, Cinar, F, Ozer, Y, Beder, L. Effects of intramuscular and peritonsillar injection of tramadol before tonsillectomy: a double blind, randomized, placebo-controlled clinical trial. Int J Pediatr Otorhinolaryngol 2008;72:241–8CrossRefGoogle ScholarPubMed
17 Shipton, EA. Tramadol: present and future. Anesth Intensive Care 2000;28:363–74CrossRefGoogle ScholarPubMed
18 Akkaya, T, Bedirli, N, Ceylan, T, Matkap, E, Gulen, G, Elverici, O et al. Comparison of intravenous and peritonsillar infiltration of tramadol for postoperative pain relief in children following adenotonsillectomy. Eur J Anaesthesiol 2009;26:333–7CrossRefGoogle ScholarPubMed