Tramadol For Management Research Articles

Preemptive Intravenous Paracetamol with or without Tramadol for Postoperative Pain After Elective Abdominal Surgery: a retrospective study

Introduction and aim: Prevention or reduction of postoperative (PO) pain is still a challenge, as it had a different drawbacks on the healing process and patient quality of life. The current study aimed to evaluate the value of preemptive paracetamol with or without tramadol in management of postoperative pain control after abdominal surgery.
 Methodology: This is a retrospective study of 90 patients who submitted to elective abdominal surgery. Patients were classified into three equal groups. The first for paracetamol, the second for paracetamol-tramadol and the third for placebo (saline). One hour before surgery a dose of paracetamol (1 gm diluted in 100 ml saline) was administered for the first two groups, in addition to 100 mg of intravenous tramadol to the second group. The primary outcome was PO pain in the first 24 hours after surgery. The secondary outcomes include time for the first analgesic request and cumulative dose of analgesia. Also, nausea and vomiting were documented. 
 Results: The group of paracetamol-tramadol was associated with significant lower VAS score at 4, 6, 8, 10 and 12 hours postoperatively than paracetamol alone or saline groups. Time to the first analgesic request was significantly longer in paracetamol-tramadol (138.00±24.41 minutes) than paracetamol alone (100.0±31.84 minutes) or saline group (82.33±23.73 minutes). The total cumulative analgesia in the first PO Day was significantly lower in paracetamol-tramadol (158.33±79.96 mg) than paracetamol (245.00±73.52 mg) or saline group (276.67±75.12 mg). Nausea and vomiting were reported in 9, 8 and 10 in paracetamol, paracetamol-tramadol and saline groups respectively with no significant differences.
 Conclusion: The use of preemptive paracetamol alone or combined with tramadol is an effective intervention to reduce the postoperative pain after abdominal surgery. It reduces the use of postoperative analgesics with subsequent effect on the cost and healthcare system.

Comparison of Ketamine and Tramadol in Management of Acute Pain; a Systematic Review.

Management of pain is an important part of care in the emergency department (ED). Tramadol and Ketamine have both been introduced as alternatives to opioids in the ED and post-operative setting. In this study, we conducted a systematic review of available literature to compare the analgesic efficacy, and side effect profile of these two medications in management of severe acute pain. This is a systematic review based on the PRISMA protocol. In this study, peer-reviewed papers published by March 3, 2020, which compared analgesic effects of tramadol and ketamine in management of acute pain were included. The initial search of online databases identified 2826 non-duplicate records. Finally, three papers available in full text were analyzed for study quality. The results show that ketamine has consistently been shown to be superior to tramadol for pain control and causes fewer significant side effects. Results of this review show that low-dose ketamine is more effective than tramadol in pain control, while causing fewer side effects.

Is Metoclopramide an Alternative to Tramadol in Management of Post‐operative Pain? An Experimental Study*

In this study, metoclopramide was compared with other pharmacological agents for preventing post-operative pain. Sixty Sprague-Dawley male rats, weighing 310-345 g were included in the study; 1 cm surgical incision, including skin, facia, and muscle was made to the plantar surface of rear foot of all anaesthetized rats. Rats were randomized into four groups. In group 1 (group S) 2 cm3 saline, in group 2 (group M) 2 cm3 metoclopramide (5 mg/kg) in group 3 (group T) 2 cm3 tramadol (45 mg/kg), in group 4 (group M+T) half doses of group M and group T was given intraperitoneally. Post-operative pain was assessed after 2 h, first and second days of incision. Post-operative pain scores were found to be significantly lower in group M, group T and group M+T when compared with the control group. But there was no significant difference between these groups. We concluded that metoclopramide, with low cost, fewer side-effects and being significantly effective for preventing post-operative pain, can be an alternative to tramadol.