title: Post-herniorrhapy infiltration of tramadol versus bupivacaine for postoperative pain relief: a randomized study.
abstract: OBJECTIVE
  Inguinal hernia repair is frequently associated with persistent postoperative discomfort and pain and late discharge from the hospital. We evaluated the postoperative analgesic effect of local wound infiltration with tramadol following herniorrhaphy among adult patients.
  
  
  METHODS
  Forty-three adult male patients were randomly assigned to two groups; group T (n=23) received tramadol 1 mg/kg in 10 mL 0.9% normal saline and group B (n=20) received 10 mL of 0.25% bupivacaine, both as a local wound infiltration prior to skin closure. Postoperatively, pain severity, time to first analgesic requirement, analgesic consumption, and incidence of side effects were recorded.
  
  
  RESULTS
  During the first postoperative day, there was a significant difference between the two groups in the recorded visual analog scale rating higher in group B (P<.05) and the time to first analgesic requirement (6.6A+/-0.99 hours in group B vs 3.7+/-0.74 hours in group T; P<.05). There was no difference in the incidence of side effects among the two groups. Postoperative consumption of fentanyl and diclofenac was higher in group B than group T (65% vs 18% and 80% vs 21.7%, respectively, P<or=.005).
  
  
  CONCLUSIONS
  Locally infiltrated tramadol prior to herniorrhaphy wound closure provides better pain relief compared to bupivacaine in adult patients.
authors.affiliation: Department of Anaesthesia, Faculty of Medicine, King Abdalaziz University Hospital, Jeddah, Saudi Arabia.
authors.forename: Abdullah M
authors.initials: AM
authors.lastname: Kaki
authors.forename: Waleed
authors.initials: W
authors.lastname: Al Marakbi
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use; D002045:Bupivacaine / Q000008:administration & dosage / Q000627:therapeutic use*; D004008:Diclofenac / Q000008:administration & dosage / Q000627:therapeutic use; D005283:Fentanyl / Q000008:administration & dosage / Q000627:therapeutic use; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac; D014147:Tramadol; D005283:Fentanyl; D002045:Bupivacaine