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.
Department of Anaesthesiology, University of Hong Kong, Queen Mary Hospital, Hong Kong.
K F
KF
Ng
S L
SL
Tsui
J C
JC
Yang
E T
ET
Ho
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