title: The efficacy of intravenous paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children.
abstract: OBJECTIVE
  To evaluate the efficacy and the quality of recovery with intravenous (IV) paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children.
  
  
  METHODS
  Prospective, randomized, double-blinded clinical trial.
  
  
  METHODS
  Operating room and Postanesthesia Care Unit (PACU) of a university-affiliated hospital.
  
  
  METHODS
  64 ASA physical status I and II children, aged 6 to 16 years, scheduled for adenotonsillectomy.
  
  
  METHODS
  All patients were premedicated with oral midazolam 0.5 mg/kg 30 minutes before surgery. Patients were randomized to two groups following induction of general anesthesia. The paracetamol group (n = 32) received 15 mg/kg of IV paracetamol and the tramadol group (n = 32) received 1.0 mg/kg of IV tramadol.
  
  
  METHODS
  Modified Hannallah pain scores, emergence agitation, Aldrete scores, sedation scores, time to first administration of analgesic, heart rate, and mean arterial blood pressure were recorded for each patient. Data were recorded every 5 minutes for the first 30 minutes and every 10 minutes for the remaining 30 minutes in the PACU, then at 2, 3, 4, 5, 6, 8, 12, and 24 hours in the ward. The frequency of postoperative nausea and vomiting also was noted. Satisfaction of parents and nurses was determined on a 4-point scale at the end of the study.
  
  
  RESULTS
  No significant demographic differences between groups were noted. No statistically significant difference was found in postoperative pain scores in either group. Agitation scores, Aldrete scores, sedation scores, and number of patients who received rescue analgesia and time to administration of rescue analgesia were similar in both groups.
  
  
  CONCLUSIONS
  The IV formulation of paracetamol was associated with similar analgesic properties and early recovery to that of IV tramadol after adenotonsillectomy in children.
authors.affiliation: Anesthesiology and Reanimation Clinic, The Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey. haleuysal@gmail.com
authors.forename: Hale Yarkan
authors.initials: HY
authors.lastname: Uysal
authors.forename: Suna Akin
authors.initials: SA
authors.lastname: Takmaz
authors.forename: Ferda
authors.initials: F
authors.lastname: Yaman
authors.forename: Bülent
authors.initials: B
authors.lastname: Baltaci
authors.forename: Hülya
authors.initials: H
authors.lastname: Başar
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D000233:Adenoidectomy; D000293:Adolescent; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D000769:Anesthesia, Inhalation; D002648:Child; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D011595:Psychomotor Agitation / Q000453:epidemiology; D014068:Tonsillectomy; D014147:Tramadol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000082:Acetaminophen; D014147:Tramadol