title: Preincisional local infiltration of tramadol at the trocar site versus intravenous tramadol for pain control after laparoscopic cholecystectomy.
abstract: OBJECTIVE
  To compare the effects of preoperative intravenous (IV) tramadol and preoperative tramadol infiltration of trocar sites on postoperative pain and postoperative nausea and vomiting (PONV) after laparoscopic cholecystectomy.
  
  
  METHODS
  Prospective, randomized study.
  
  
  METHODS
  Operating room, recovery room, and surgical ward.
  
  
  METHODS
  70 ASA physical status 1 and 2 patients, aged 20-70 years, scheduled for elective laparoscopic cholecystectomy.
  
  
  METHODS
  In Group I, patients received IV 2.0 mg/kg of tramadol; in Group II, trocar insertion points were infiltrated with 2.0 mg/kg of tramadol in 20 mL of 0.9% NaCl.
  
  
  METHODS
  Pain scores, sedation scores, postoperative analgesic requirement, and PONV were recorded at 0 and 30 minutes and one, three, 6, 12, and 24 hours. At 30 minutes and one hour, pain localization (incisional or diffuse abdominal) was also recorded.
  
  
  RESULTS
  Visual analog scale scores at 30 minutes were significantly lower in Group II [3 (0-7)] than Group I [6 (3-8)] (P < 0.001). In Group I, 91.4% of patients received sodium diclofenac, while 68.6% of Group II patients received sodium diclofenac (P = 0.002). The time to first analgesic requirement was significantly lower in Group II (P = 0.004). At the 30-minute measurement time, a significant difference was recorded between the groups in incisional pain (P < 0.001). There was also a significant difference between groups in the frequency of PONV.
  
  
  CONCLUSIONS
  Trocar site infiltration of tramadol improves early postoperative pain and decreases PONV.
authors.affiliation: Department of Anesthesiology and Reanimation, Diskapi Yildirım Beyazıt Training and Research Hospital, Ankara 06434, Turkey.
authors.forename: Erkan
authors.initials: E
authors.lastname: Matkap
authors.forename: Nurdan
authors.initials: N
authors.lastname: Bedirli
authors.forename: Taylan
authors.initials: T
authors.lastname: Akkaya
authors.forename: Haluk
authors.initials: H
authors.lastname: Gümüş
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D011446:Prospective Studies; D014147:Tramadol / Q000008:administration & dosage*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol