Postoperative pain relief in the morbidly obese patient: Feasibility study of a combined dipyrone/tramadol infusion

Abstract

The aim of the prospective clinical study was to test the feasibility of a dipyrone/tramadol combination for pain therapy after laparoscopic and open obesity surgery. The study group was made up of 29 surgical patients; 14 following a median laparotomy and 15 following a laparoscopic approach. All received a continuous intravenous infusion of dipyrone (metamizol) and tramadol for pain relief. The surgical procedure (laparotomy or laparoscopy), body mass index, postoperative analgesic requirement and pain intensity (visual analogue scale (VAS 1–10)) were documented. Following laparotomy, the combination infusion provided effective analgesia. On the first and fourth postoperative days, the pain scores at rest were 1.5 and 2.3 respectively. The pain scores did not increase significantly with movement (2.7 and 2.2 respectively). Following laparoscopic gastric banding the pain scores were less than 2.0 at rest and with movement on the first postoperative day. On the fourth postoperative day the pain scores at rest and with movement were 0.2. This feasibility study suggests that a combination of the strong non-opioid dipyrone and the atypical opioid tramadol provides good analgesia following laparotomy and laparoscopic surgery for morbid obesity.