title: Post-operative effects of tramadol administered at wound closure.
abstract: The aim of this prospective, randomized and double-blind study was to assess the effects of a high dose of the analgesic tramadol administered at the conclusion of surgery on extubation time, sedation, and post-anaesthetic shivering. Forty adult patients, ASA physical status I or II, underwent laparoscopic surgery of about 1 h duration and received a standardized anaesthesia that was maintained with isoflurane in O2/N2O. Tramadol 3 mg kg-1 (n = 20) was administered intravenously at the beginning of wound closure, and was compared with saline (n = 20). Post-anaesthetic shivering did not occur in any patient who received tramadol, whereas it occurred in 60% of the control group (P < 0.001). There were no adverse effects on time to extubation and sedation, and discharge-ready time was shorter in the tramadol group (P < 0.05 compared with control). Pain scores in the post-anaesthesia care unit (PACU) were statistically not different between the two groups, but significantly more supplemental medication was administered in the control group to treat shivering and/or pain. In conclusion, administration of a high dose of tramadol at the end of surgery prevents post-anaesthetic shivering without prolongation of extubation time, and shortens the PACU/discharge-ready time.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, OLV-Hospital, Aalst, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: De Witte
authors.forename: G W
authors.initials: GW
authors.lastname: Rietman
authors.forename: G
authors.initials: G
authors.lastname: Vandenbroucke
authors.forename: T
authors.initials: T
authors.lastname: Deloof
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000009:adverse effects; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D009325:Nausea / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*; D012768:Shivering / Q000187:drug effects; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*; D014839:Vomiting / Q000517:prevention & control
chemical_list: D009294:Narcotics; D014147:Tramadol