Postoperative patient-controlled analgesia with intravenous tramadol, intravenous fentanyl, epidural tramadol and epidural ropivacaine+fentanyl combination.
OBJECTIVE
The aim of this study was to compare the effects of IV tramadol, IV fentanyl, epidural tramadol, and an epidural ropivacaine+fentanyl combination in patient-controlled analgesia (PCA) after lower abdominal surgery.


METHODS
Eighty adult patients undergoing lower abdominal surgery were randomly allocated to one of four groups to receive analgesics with PCA pumps. Patients in group I received IV tramadol, group II patients IV fentanyl, group III patients epidural tramadol, and group IV patients an epidural infusion of 0.125% ropivacaine + 2 microg ml(-1) fentanyl combination. Analgesic effectiveness and side-effects were assessed at 1, 2, 3, 4, 5, 6, 8, 12, 16, 20, and 24 hours after surgery.


RESULTS
Adequate analgesia was achieved in all groups. The analgesia was highest in group IV (p < 0.05), and lowest in group III patients (p < 0.05). Eleven patients (55%) in group I and eight patients (40%) in group II suffered from nausea/vomiting.


CONCLUSIONS
Although adequate pain relief was achieved with all regimens that were used in the study, intravenous tramadol and intravenous fentanyl are associated with a high incidence of nausea and vomiting.
Department of Anaesthesiology and Reanimation, Faculty of Medicine, University of Gaziantep, Gaziantep, Turkey.
S
S
Aygun
H
H
Kocoglu
S
S
Goksu
M
M
Karaca
U
U
Oner
D000005:Abdomen / Q000601:surgery; D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D015360:Analgesia, Epidural / Q000379:methods; D016058:Analgesia, Patient-Controlled; D000704:Analysis of Variance; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage*; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007813:Laparotomy / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011336:Probability; D018570:Risk Assessment; D000077212:Ropivacaine; D014147:Tramadol / Q000008:administration & dosage*; D016896:Treatment Outcome
D000577:Amides; D014147:Tramadol; D000077212:Ropivacaine; D005283:Fentanyl