The use of tramadol and morphine for pain relief after abdominal hysterectomy.
OBJECTIVE
The aim of this study was to determine whether the addition of a tramadol infusion to morphine patient-controlled analgesia (PCA) results in improved analgesic efficacy compared with morphine PCA alone after abdominal hysterectomy.


METHODS
Sixty patients undergoing abdominal hysterectomy were randomized into two groups, each receiving IV morphine PCA after surgery. The tramadol group received a loading dose of tramadol (1 mg/kg) at skin closure and a postoperative infusion of tramadol at 0.2 mg/kg/h. The control group received an equivalent volume of saline at skin closure and a postoperative saline infusion.


RESULTS
The addition of a tramadol infusion to morphine PCA was associated with lower pain scores, a reduction in PCA morphine requirements (27 +/- 4.6 mg vs 40.5 +/- 5.4 mg over 24 h) and improved patient satisfaction with pain relief (p < 0.05). No intergroup differences were found with regard to sedation, nausea and antiemetic use (p > 0.05).


CONCLUSIONS
The addition of a tramadol infusion to morphine PCA resulted in improved analgesic efficacy and reduced morphine requirements compared with morphine PCA alone after abdominal hysterectomy.
Kocabas
S
S
Department of Anesthesiology and Reanimation, Ege University Faculty of Medicine, Turkey.
Karaman
S
S
Uysallar
E
E
Firat
V
V
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D016058:Analgesia, Patient-Controlled; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D007262:Infusions, Intravenous; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D014147:Tramadol / Q000627:therapeutic use*
D000701:Analgesics, Opioid; D014147:Tramadol; D009020:Morphine