title: Does tramadol wound infiltration offer an advantage over bupivacaine for postoperative analgesia in children following herniotomy?
abstract: BACKGROUND
  It has been demonstrated that tramadol is an effective analgesic. We aimed to compare postoperative analgesic effects of wound infiltration with tramadol (T) or bupivacaine (B) and intramuscular tramadol (I) after herniotomy in children.
  
  
  METHODS
  In this study, 75 children were randomly assigned to group T, group B and group I. Wound infiltration was performed to the patients in group T (2 mg.kg-1 tramadol in 0.2 ml.kg-1 saline) and group B (0.2 ml.kg-1 0.25% bupivacaine) into the surgical incision. Twenty minutes before the end of the surgery 2 mg.kg-1 tramadol was injected i.m. in group I. Faces pain scale was used for assessing pain severity. Patients with pain score>2 were treated with paracetamol. The frequency of side effects and analgesic use were recorded. Patients were discharged on the next day.
  
  
  RESULTS
  No side effects were recorded in any group. The pain scores of the patients at the first, fourth and eighth hours were significantly higher in group B and group I than group T (P<0.05). The pain scores of the patients at the first hour were significantly higher in group I compared with group B (P<0.05). Average time to first analgesic requirement was significantly longer in group T (6.72+/-4.09 h after herniotomy than both group I (4.49+/-3.9 h) and group B (6.04+/-3.7 h) (P<0.05).
  
  
  CONCLUSIONS
  Wound infiltration with tramadol may be a good choice for postoperative analgesia in children having inguinal herniotomy.
authors.affiliation: Department of Anesthesiology, School of Medicine, Abant Izzet Baysal University, Konuralp/Duzce, Turkey. demiryvz@yahoo.com
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Demiraran
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Ilce
authors.forename: Buket
authors.initials: B
authors.lastname: Kocaman
authors.forename: Pervin
authors.initials: P
authors.lastname: Bozkurt
mesh_terms: D000287:Administration, Topical; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000009:adverse effects / Q000627:therapeutic use*; D002045:Bupivacaine / Q000009:adverse effects / Q000627:therapeutic use*; D002675:Child, Preschool; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D007273:Injections, Intramuscular; D008297:Male; D008874:Midazolam / Q000627:therapeutic use; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D014147:Tramadol; D008874:Midazolam; D002045:Bupivacaine