Comparison of caudal morphine and tramadol for postoperative pain control in children undergoing inguinal herniorrhaphy.
OBJECTIVE
We compared the quality and duration of analgesia, the effect on perioperative sevoflurane requirement after a single, presurgical caudal block with either tramadol or morphine in children undergoing inguinal herniorrhaphy. Our study was also designed to evaluate the preemptive analgesic efficacy of morphine administered caudally in children.


METHODS
Patients were randomly divided into three groups to receive 2 mg.kg-1 tramadol (group T, preemptive group) or morphine sulphate 0.03 mg.kg-1 (group M, preemptive group). The patients in control group (group C, postincisional group) received morphine sulphate 0.03 mg.kg-1 at the end of surgery, caudally. Cardiorespiratory data, sedation and pain were recorded for 24 h following recovery from anaesthesia.


RESULTS
There were no differences between the three groups in baseline blood pressure or heart rate; or duration of anaesthesia, surgery. The inhaled sevoflurane concentration was significantly lower in group M and group T than in the control group. The quality and duration of postoperative pain relief did not differ between the three groups. There were no intergroup differences in postoperative nausea, vomiting, or other complications.


CONCLUSIONS
Caudal tramadol (2 mg.kg-1) provided reliable postoperative analgesia similar to caudal morphine (0.03 mg.kg-1) in quality and duration of pain relief in our study children who were undergoing herniorrhaphy. We also concluded that presurgical caudal morphine or tramadol reduced perioperative sevoflurane requirements and either presurgical or postsurgical caudal morphine did not make any difference to postoperative analgesia.
Ozcengiz
D
D
Department of Anaesthesiology, Faculty of Medicine, Cukurova University, 01330 Balcal 1, Adana, Turkey. ecenaz@mail.cu.edu.tr
Gunduz
M
M
Ozbek
H
H
Isik
G
G
D015360:Analgesia, Epidural; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D002420:Cauda Equina; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D008738:Methyl Ethers / Q000008:administration & dosage; D009020:Morphine / Q000008:administration & dosage*; D009407:Nerve Block; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D011300:Preoperative Care; D000077149:Sevoflurane; D014147:Tramadol / Q000008:administration & dosage*
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D014147:Tramadol; D009020:Morphine