Comparison of analgesic effect of tramadol alone and a combination of tramadol and paracetamol in day-care laparoscopic surgery.
OBJECTIVE
To compare the analgesic efficacy of tramadol alone (1.5 mg kg(-1)) with a tramadol (1 mg kg(-1)) and paracetamol combination in day-care laparoscopic patients.


METHODS
The analgesic efficacy of intravenous tramadol alone (1.5 mg kg(-1)) (group T) was compared with a combination of intravenous tramadol (1 mg kg(-1)) and oral paracetamol 1 g (group TP) in 60 day-care laparoscopic patients in a prospective randomized double-blind clinical trial in a tertiary care hospital. Intraoperative haemodynamic responses and postoperative visual analogue scores were used to assess the analgesic efficacy.


RESULTS
Only one patient (in group T) received a single dose of rescue analgesia intraoperatively. The highest pain scores were recorded at 30 min postoperatively in both groups, and rescue analgesia was needed in eight patients in group T and in 13 patients in group TP (P = 0.08). The incidence of moderate-to-severe nausea was high in group T (P = 0.001).


CONCLUSIONS
We conclude that reducing the dose of tramadol to 1 mg kg(-1) and combining it with paracetamol 1 g orally decreased the incidence of side effects of tramadol without reducing analgesic efficacy.
Ali
Mohammad
M
Department of Anaesthesia, Aga Khan University, Karachi, Pakistan. ali.mohammad@aku.edu
Khan
Fauzia A
FA
D000082:Acetaminophen / Q000008:administration & dosage*; D000293:Adolescent; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D001794:Blood Pressure / Q000187:drug effects; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D010535:Laparoscopy; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control; D011446:Prospective Studies; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol