title: Tramadol wound infiltration is not different from intravenous tramadol in children: a randomized controlled trial.
abstract: OBJECTIVE
  The purpose of this trial was to assess if tramadol wound infiltration is superior to intravenous (IV) tramadol after minor surgical procedures in children because tramadol seems to have local anesthetic-like effect.
  
  
  METHODS
  Randomized double-blind controlled trial.
  
  
  METHODS
  Postanesthesia care unit.
  
  
  METHODS
  Forty children, American Society of Anesthesiologists physical status I or II, scheduled to elective inguinal hernia repair.
  
  
  METHODS
  Children were randomly distributed in 1 of 2 groups: IV tramadol (group 1) or subcutaneous infiltration with tramadol (group 2). At the end of the surgery, group 1 received 2 mg/kg tramadol (3 mL) by IV route and 3-mL saline into the surgical wound; group 2 received 2 mg/kg tramadol (3 mL) into the surgical wound and 3-mL saline by IV route.
  
  
  METHODS
  In the postanesthesia care unit, patients were evaluated for pain intensity, nausea and vomiting, time to first rescue medication, and total rescue morphine and dipyrone consumption.
  
  
  RESULTS
  Pain scores measured during the postanesthesia recovery time were similar between groups. Time to first rescue medication was shorter, but not statistically significant in the IV group. The total dose of rescue morphine and dipyrone was also similar between groups.
  
  
  CONCLUSIONS
  We concluded that tramadol was effective in reducing postoperative pain in children, and there was no difference in pain intensity, nausea and vomiting, or somnolence regarding IV route or wound infiltration.
authors.affiliation: Department of Anesthesia, Surgery Division, Pediatric Anesthesia Unit, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Ana Laura Albertoni
authors.initials: AL
authors.lastname: Giraldes
authors.affiliation: Pain Management Service, Cancer Institute of the State of Sao Paulo, São Paulo, Brazil. Electronic address: angela.sousa0309@gmail.com.
authors.forename: Angela Maria
authors.initials: AM
authors.lastname: Sousa
authors.affiliation: Department of Anesthesia and Pain Management, Santa Paula Hospital, São Paulo, Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Slullitel
authors.affiliation: Pain Management Service, Cancer Institute of the State of Sao Paulo, São Paulo, Brazil.
authors.forename: Gabriel Magalhães Nunes
authors.initials: GM
authors.lastname: Guimarães
authors.affiliation: Department of Anesthesia, University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Melina Geneviève Mary Egan
authors.initials: MG
authors.lastname: Santos
authors.affiliation: Department of Anesthesia, University Hospital, University of São Paulo, São Paulo, Brazil.
authors.forename: Renata Evangelista
authors.initials: RE
authors.lastname: Pinto
authors.affiliation: Department of Anesthesia, Hospital das Clinicas from the University of São Paulo, São Paulo, Brazil.
authors.forename: Hazem Adel
authors.initials: HA
authors.lastname: Ashmawi
authors.affiliation: Department of Anesthesia, Surgery Division, Pediatric Anesthesia Unit, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Rioko Kimiko
authors.initials: RK
authors.lastname: Sakata
mesh_terms: D061605:Administration, Intravenous; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D002648:Child; D002675:Child, Preschool; D004311:Double-Blind Method; D005260:Female; D006552:Hernia, Inguinal / Q000601:surgery; D059685:Herniorrhaphy / Q000379:methods; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy; D011182:Postoperative Care; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology; D014147:Tramadol / Q000008:administration & dosage* / Q000493:pharmacokinetics*
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol
keywords: Hernioplasty; Infiltration anesthesia; Intravenous administration; Postoperative pain; Tramadol