Increased nausea and dizziness when using tramadol for post-operative patient-controlled analgesia (PCA) compared with morphine after intraoperative loading with morphine.
Thirty-eight ASA I-III patients undergoing lower abdominal operations were randomly allocated to receive either morphine (group M, patient-controlled analgesia bolus = 1 mg of morphine) or tramadol (group T, patient-controlled analgesia bolus = 10 mg of tramadol) for post-operative patient-controlled analgesia (PCA) after receiving morphine intraoperatively. There were no between-group differences in the pain, sedation or vomit scores. The nausea scores were significantly higher in group T in the initial 20 h and between 32 and 36 h (P < 0.01, 0-4 and 8-12 h; P < 0.05, 4-8, 12-16, 16-20 and 32-36 h). The incidence of dizziness was also significantly higher in group T (68.4% vs. 31.6%, group T vs. group M, P < 0.05). There was no difference in the overall satisfaction. We conclude that the use of tramadol, compared with morphine, for post-operative PCA after intraoperative loading with morphine is associated with more nausea and dizziness, but with similar sedation, quality of analgesia and patient satisfaction.
Ng
K F
KF
Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
Tsui
S L
SL
Yang
J C
JC
Ho
E T
ET
D000005:Abdomen / Q000601:surgery; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003243:Consciousness / Q000187:drug effects; D004244:Dizziness / Q000139:chemically induced*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D010149:Postoperative Pain / Q000517:prevention & control; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000139:chemically induced*; D011292:Premedication; D013997:Time Factors; D014147:Tramadol / Q000008:administration & dosage / Q000009:adverse effects*
D000701:Analgesics, Opioid; D014147:Tramadol; D009020:Morphine