Comparison Between the Effects of Preoperative (Preemptive) and Intraoperative use of Tramadol on Post-Operative Pain

Abstract

Aim: The aim of this study was to investigate the efficiency of tramadol treatment in prevention of postoperative pain in two different groups in which tramadol applied before skin incision (group 1/preemptive), and intraoperatively (group 2/preventive) at the same dose. Methods: The study was designed as a randomized prospective study. The patients in group 1 (n=25) received 1.5 mg/kg tramadol IV 15 minutes before induction of anesthesia. The patients in group 2 (n=25) received the same dose of tramadol after the incision. Postoperative pain was assessed with 10 cm visual analogue scale (VAS) after extubation, before the first analgesic request and at the 6th, 12th, 18th and 24th hours, postoperatively. Paracetamole (15 mg/kg) and, if it was not sufficient, pethidine (1 mg/kg) were used for postoperative analgesia. Total doses of analgesics and side effects were recorded. Results: This study showed no significant differences in pain scores and total doses of analgesics except for time to first analgesic requirement [(t(analgezia)) 24.21 +/- 8.2 min. in group 1 and 42.18 +/- 9.8 min. in group 2]. Conclusion: In this study, any difference between preemptive and preventive properties of iv tramadol could not be demonstrated. Applying route of tramadol and the possibility that anesthetic drugs can suppress central sensitization are thought to be reasons.