The effects of intraperitoneal tramadol, tenoxicam and bupivacaine on pain relief after laparoscopic gynecological procedures

Abstract

Purpose: Patients undergoing laparoscopic procedures may experience postoperative pain. We conducted a randomized, double-blinded, placebo-controlled trial to evaluate the effectivenesses of peritoneal tramadol as an opioid analgesic, tenoxicam as an anti-imflammatory drug and bupivacaine as a local anesthetic. Methods: Patients were randomly assigned to one of four groups of 20 patients each. Group A received 50 mg tramadol (in 20 ml volume with 0.9% saline), group B received 20 mg tenoxicam (in 20 ml volume with 0.9% saline), group C received 20 ml 0.9% saline and group D received 50 mg bupivacaine HCl in 20 ml volume (10 ml 0.5% bupivacaine with 10 ml 0.9% saline) after surgery. Pain was assessed using a visual analog scale and a verbal rating scale at 30 and 60 min, and 2 and 4 h after surgery. Results: Pain intensity and analgesic requirements were significantly less in the group receiving intraperitoneal tramadol, tenoxicam and bupivacaine compared to placebo group. The pain scores of tenoxicam group at 30 and 60 min, and 2 h after surgery were significantly lower than those of the group B, C and D. There was no statistically significant difference in any group at 4 h after surgery. Conclusion: The results indicate that intraperitoneal application of tramadol, tenoxicam and bupivacaine is simple, cheap and effective for reducing pain after laparoscopic gynecological operations.