Analgesia after day case laparoscopic sterilisation. A comparison of tramadol with paracetamol/dextropropoxyphene and paracetamol/codeine combinations.
In a prospective, double-blind trial we compared the analgesic efficacy of tramadol during the first 24 h after day case laparoscopic sterilisation with two commonly prescribed combination analgesics. Seventy-five women were allocated randomly to receive oral paracetamol 325 mg/dextropropoxyphene hydrochloride 32.5 mg, tramadol 50 mg or paracetamol 500 mg/codeine phosphate 30 mg as required after a standardised anaesthetic technique. There were no significant differences in average or worst pain, sleep disturbance, mobility, number of tablets taken, satisfaction or preference for stronger analgesia (26.2% of all patients). The incidences of nausea and vomiting were comparable between groups. There was a trend towards a lower incidence of central nervous system side-effects (drowsiness, dizziness, headache) in the paracetamol/codeine group. Tramadol may be considered an alternative analgesic for day case surgery although analgesic regimens of greater efficacy are required for many patients. The relative incidence of side-effects for tramadol and other analgesics requires further evaluation.
Crighton
I M
IM
University Department of Anaesthesia, Queen's Medical Centre, Nottingham, UK.
Hobbs
G J
GJ
Wrench
I J
IJ
D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000698:Analgesia; D000701:Analgesics, Opioid; D003061:Codeine / Q000627:therapeutic use; D011431:Dextropropoxyphene / Q000627:therapeutic use; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D010535:Laparoscopy; D010149:Postoperative Pain / Q000188:drug therapy*; D013246:Sterilization, Tubal; D014147:Tramadol
D000701:Analgesics, Opioid; D004338:Drug Combinations; D000082:Acetaminophen; D014147:Tramadol; D011431:Dextropropoxyphene; D003061:Codeine