Analgesic efficacy of topical tramadol in the control of postoperative pain in children after tonsillectomy.
OBJECTIVE
Pain control after tonsillectomy is still a controversial issue. Topical approaches have the advantage of pain control with good patient acceptability. Therefore, this study was conducted to evaluate the effects of topical tramadol on postoperative pain and morbidity in children undergoing tonsillectomy.


METHODS
A prospective, randomized, double-blind, controlled clinical study was designed. Forty children aged between 4 and 15 years, ASA I-II, scheduled for elective tonsillectomy and/or adenoidectomy were randomized into two groups. For patients in Group T (n = 20) swabs soaked with 2 mg/kg tramadol diluted in 10 ml saline were applied to both of their tonsillar fossa for 5 min; in the control group (n = 20) swabs soaked with 10 ml saline were applied. Postoperative pain scores, bleeding, nausea, vomiting, abdominal discomfort, constipation, pain in the throat, painful swallowing, fever, otalgia, trismus, and halitosis were recorded at the first, fifth, thirteenth, seventeenth, twenty-first, and twenty-fourth postoperative hours and the week after tonsillectomy.


RESULTS
Pain scores were found to be significantly lower at the 21st hour and on postoperative day seven in the tramadol group compared with the control group (p < 0.05). Mean daily pain scores ranged from Day 1: 0.34 (±0.21) to Day 7: 0.11 (±0.08) in the tramadol group and Day 1: 0.53 (±0.14) to Day 7: 0.42 (±0.15) in the control group. There were no significant differences in morbidity between the groups (p > 0.05).


CONCLUSIONS
Topical 5% tramadol with its local anesthetic effect seems to be an easy, safe, and comfortable approach for pain management in children undergoing tonsillectomy.
Akbay
Buket Kocaman
BK
Department of Anesthesiology and Reanimation, Faculty of Medicine, Duzce University, Duzce, Turkey. buketkocaman@gmail.com
Yildizbas
Sahnur
S
Guclu
Ender
E
Yilmaz
Suleyman
S
Iskender
Abdulkadir
A
Ozturk
Ozcan
O
D000082:Acetaminophen / Q000627:therapeutic use; D000233:Adenoidectomy; D000287:Administration, Topical; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000188:drug therapy*; D014066:Palatine Tonsil; D014068:Tonsillectomy; D014147:Tramadol / Q000008:administration & dosage* / Q000627:therapeutic use*
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol