Comparison of preemptive analgesic effect of intravenous ketorolac versus tramadol in pediatric inguinal herniotomy: A randomized double blind study

Abstract

BackgroundThis study was designed to evaluate the preemptive analgesic efficacy of ketorolac tromethamine versus tramadol in providing postoperative pain relief and improving discharge criteria in children undergoing inguinal herniotomy.MethodsEighty children, aged between 2 and 12 years, undergoing inguinal herniotomy were randomly allocated to receive intravenous 1 mg/kg tramadol (group T; n = 40) or 1 mg/kg ketorolac (group K; n = 40), immediately after induction of general anesthesia.Heart rate, arterial pressure and oxygen saturation were monitored. Postoperative pain was assessed at regular intervals until discharge. Postoperative rescue analgesic (15 paracetamol mg/kg rectally) was supplemented when pain score was >4. Time to first analgesia, requirement for additional analgesics, sedation level, bleeding time and side effects were noted.ResultsTime to first analgesia was significantly longer and total consumption of rescue analgesic was significantly lower in tramadol group compared with ketorolac group .There were no significant changes in intraoperative heart rate, and arterial pressure between groups. Intraoperative bleeding time was within normal in both groups, but it was significantly higher in the ketorolac. Adverse effects were not observed.ConclusionsTramadol provided longer duration of postoperative analgesia and reduced requirement for rescue analgesic compared with ketorolac in children undergoing inguinal herniotomy.