title: Comparative study of the analgesic efficacy of rectal tramadol versus intravenous tramadol for adult tonsillectomy.
abstract: BACKGROUND
  The optimal method for intra- and post-operative analgesia for adult tonsillectomy is uncertain. Tramadol hydrochloride is an analgesic with mixed mu and nonopioid activities, having less/no respiratory depression.
  
  
  OBJECTIVE
  The aim of our study was to compare the analgesic efficacy and nausea/vomiting produced by tramadol via intravenous and rectal administration during the first 24 h after anesthesia for adult tonsillectomy.
  
  
  METHODS
  The study design was prospective, randomized, single blind and hospital based. Forty adult patients of ASA grade 1 and 2 posted for tonsillectomy were randomized to receive either intravenous tramadol (1 mg/kg) (n=20) Group A or rectal tramadol (1.5-2 mg/kg), maximum 100 mg (n=20), Group B immediately after the induction of anesthesia. Pain measurement was performed using visual analogue scale. Rescue analgesia was given when the VAS was ≥3 in the postoperative period up to 24 h. Complaint of nausea/vomiting was recorded during the same period.
  
  
  RESULTS
  Duration of analgesia was prolonged and requirement of rescue analgesics was less with the suppository group. Nausea and vomiting were lower with the suppository group.
  
  
  CONCLUSIONS
  The rectal route of tramadol is a better alternative to the intravenous route in comparison with the duration of analgesia and nausea/vomiting for adult tonsillectomy.
authors.affiliation: Department of Anaesthesiology, M. P. Shah Medical College, Jamnagar - 361 008, Gujarat, India.
authors.forename: Hina N
authors.initials: HN
authors.lastname: Gadani
authors.affiliation: Department of Anaesthesiology, M. P. Shah Medical College, Jamnagar - 361 008, Gujarat, India.
authors.forename: Virendra Pratap
authors.initials: VP
authors.lastname: Chaudhary
keywords: Analgesia; intravenous; postoperative pain; suppository; tramadol