title: Patient-controlled analgesia with tramadol versus tramadol plus ketorolac.
abstract: OBJECTIVE
  In this double-blinded, randomized controlled trial, we compared the clinical advantages and disadvantages of patient-controlled-analgesia (PCA) with continuous infusion (CI) with tramadol alone versus a combination of tramadol plus ketorolac in the management of postoperative pain after major abdominal surgery.
  
  
  METHODS
  Sixty adult patients were randomly assigned to 2 groups. Group T, was given 10 mg/mL tramadol and Group TK was given 1.50 mg/mL ketorolac plus 5 mg/mL tramadol. After an i.v. loading dose of 0.07 mL/kg, the demand bolus injection was set at 0.2 mL, with a lockout interval of 30 min, and a continuous background i.v. infusion was set at 1.5 mL/h. Data of PCA demand, dose delivered and total analgesic consumption were retrieved from the computer memory bank of PCA device. Visual analogue scale at rest, sedation score and the occurrence of adverse effects were assessed every 3 h for 18 h.
  
  
  RESULTS
  No significant differences were found with regard to pain scores and side effects. Patients in Group TK were significantly more alert.
  
  
  CONCLUSIONS
  We concluded that the combination of ketorolac plus tramadol in the same PCA device was an effective and safe treatment for postoperative analgesia in abdominal surgery.
authors.affiliation: Department of Anesthesiology and Intensive Care, Orthopedic Traumatological Center, Azienda Ospedaliera Universitaria Careggi, Florence, Italy. alepri@inwind.it
authors.forename: A
authors.initials: A
authors.lastname: Lepri
authors.forename: S
authors.initials: S
authors.lastname: Sia
authors.forename: S
authors.initials: S
authors.lastname: Catinelli
authors.forename: R
authors.initials: R
authors.lastname: Casali
authors.forename: G
authors.initials: G
authors.lastname: Novelli
mesh_terms: D000005:Abdomen / Q000601:surgery; D000368:Aged; D016058:Analgesia, Patient-Controlled / Q000009:adverse effects; D000701:Analgesics, Opioid / Q000009:adverse effects / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D020910:Ketorolac / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D014147:Tramadol / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014147:Tramadol; D020910:Ketorolac