title: Analgesia with paracetamol/tramadol vs. paracetamol/codeine in one day-surgery: a randomized open study.
abstract: OBJECTIVE
  The analgesic efficacy of two fixed combinations of tramadol/paracetamol (TP 37.5/325 mg) and codeine/paracetamol (CP 30/500 mg) was compared in 122 patients undergoing one-day surgical procedures (hallux valgus, haemorrhoidectomy, varicectomy and inguinal hernia repair), randomly treated with TP 37.5/325 mg or CP 30/500 mg one tablet after surgery ended, followed by one tablet four times daily for 48 hours.
  
  
  METHODS
  Pain was assessed by a Verbal Rating Scale (VRS). Whenever the VRS score was > or = 3, the patient was given a "rescue medication" (tramadol 50 mg s.c.). The quality of life (time to return to normal daily activities, nightly rest, appetite, mood, deambulation, and self-care) was assessed in the postoperative period. Patients were asked to give their judgment on the surgical procedure and postoperative outcome.
  
  
  RESULTS
  The results indicate that TP 37.5/325 mg was superior to CP 30/500 mg in terms of higher analgesic efficacy (VSR at 24 hours: CP 30/500, 2.52 +/- 0.86 vs. TP 37.5/325, 1.40 +/- 0.76; p < 0.001), less patients reporting adverse events (CP 30/500: 62% vs. TP 37.5/325: 36%; p < 0.01), less patients requiring rescue medications (CP 30/500: 18.2% vs. TP 37.5/325: 5.5%; p < 0.01), and more favorable judgment (scored "excellent" by 16% and 54.5% of CP 30/500 or TP 37.5/325-treated patients, respectively; p < 0.001).
  
  
  CONCLUSIONS
  We conclude that a fixed association of tramadol/paracetamol is a valuable and safe tool for pain management in day hospital surgery, especially whenever any effort is done to reduce the time for hospitalization.
authors: Hospital M. Scarlato, Operative Unit of Anesthesia and Intensive Care, ASL Salerno, Italy.
authors: G
authors: G
authors: Alfano
authors: M
authors: M
authors: Grieco
authors: A
authors: A
authors: Forino
authors: G
authors: G
authors: Meglio
authors: M C
authors: MC
authors: Pace
authors: M
authors: M
authors: Iannotti
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000698:Analgesia; D003061:Codeine / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000188:drug therapy*; D014147:Tramadol / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000082:Acetaminophen; D014147:Tramadol; D003061:Codeine