title: Efficacy of tramadol as a preincisional infiltration anesthetic in children undergoing inguinal hernia repair: a prospective randomized study.
abstract: BACKGROUND
  Preincisional local anesthetic infiltration at the surgical site is a therapeutic option for postoperative pain relief for pediatric inguinal hernia. Additionally, tramadol has been used as an analgesic for postoperative pain in children. Recently, the local anesthetic effects of tramadol have been reported. The aim of this study was to determine both the systemic analgesic and the local anesthetic effects of tramadol and to determine how it differs from bupivacaine when administered preincisionally.
  
  
  METHODS
  Fifty-two healthy children, aged 2-7 years, who were scheduled for elective herniorrhaphy were randomly allocated to receive either preincisional infiltration at the surgical site with 2 mg/kg tramadol (Group T, n=26) or 0.25 mL/kg 0.5% bupivacaine (Group B, n=26). At the time of anesthetic administration, perioperative hemodynamic parameters were recorded. The pain assessments were performed 10 minutes after the end of anesthesia and during the first 6-hour period, using pain scores. The time of first dose of analgesia and need for additional analgesia were recorded.
  
  
  RESULTS
  Between T and B groups, the anesthesia time, perioperative hemodynamic changes, and pain scores were not statistically different. However, in group B, the postoperative analgesic requirement was higher than in group T.
  
  
  CONCLUSIONS
  Tramadol shows equal analgesic effect to bupivacaine and decreases additional analgesic requirement, when used for preincisional infiltration anesthesia in children undergoing inguinal herniorrhaphy.
authors.affiliation: Department of Pediatric Surgery, Bülent Ecevit University, Kozlu, Zonguldak, Turkey.
authors.forename: Kemal Varım
authors.initials: KV
authors.lastname: Numanoğlu
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Bülent Ecevit University, Kozlu, Zonguldak, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Ayoğlu
authors.affiliation: Department of Pediatric Surgery, Bülent Ecevit University, Kozlu, Zonguldak, Turkey.
authors.forename: Duygu TatlıEbubekir
authors.initials: DT
authors.lastname: Er
keywords: bupivacaine; pain scores; postoperative analgesia