Tramadol for pain relief in children undergoing adenotonsillectomy: a comparison with dextromethorphan.
OBJECTIVE
Establishment of good analgesia is of major concern in the postoperative period after adenotonsillectomy. The aim of this study was to compare the effects of dextromethorphan and tramadol on postoperative pain after adenotonsillectomy in children.


METHODS
Randomized study.


METHODS
Ninety ASA class I, II (children age, 4-10 years) scheduled for adenotonsillectomy were randomized into three groups to receive placebo syrup (control group), 1 mg/kg dose of dextromethorphan cough syrup oral (Dex group) or oral placebo syrup (Tramadol group), 30 minutes before arrival in the operating room. Then during induction of anesthesia group control received 0.9% physiological saline, group Dex received 0.9% physiological saline, group Tramadol (1 mg/kg) of tramadol hydrochloride intravenously, in a total volume of 4 mL. Postoperative analgesic requirements and side effects were recorded. Pain was assessed by face scale every hour up to 6 hours postop.


RESULTS
There were no statistically significant differences in age, weight, and sex between groups (P > .05). There were statistically significant differences in, pain scores in first time postoperatively and further analgesic requirements (P < .05). All patients in placebo group (100%), two patients in the tramadol group (6.6%), and nine patients in dextromethorphan group (40%) required supplementary meperidine in recovery room. The incidence of nausea and vomiting was 5.5% in the Dextromethorphan group, 10% in the tramadol group, 6.6% in the control group; there was no significant difference between the groups (P > .05).


CONCLUSIONS
Intravenous tramadol (1 mg/kg) is more suitable than 1 mg/kg dose of dextromethorphan cough syrup oral in reducing posttonsillectomy pain in children.
Ali
Sahmeddini Mohammad
SM
Department of Anesthesiology, Faghihi Hospital, Shiraz Medical University, Shiraz, Iran. sahmeddini@pearl.sums.ac.ir
Shahrbano
Shahbazy
S
Ulhaq
Taregh Shuja
TS
D000233:Adenoidectomy / Q000379:methods*; D000284:Administration, Oral; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003915:Dextromethorphan / Q000008:administration & dosage / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011446:Prospective Studies; D014068:Tonsillectomy / Q000379:methods*; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000701:Analgesics, Opioid; D018691:Excitatory Amino Acid Antagonists; D014147:Tramadol; D003915:Dextromethorphan