Comparison of preemptive analgesic efficacy of tapentadol and tramadol on postoperative pain in patients of lumbar laminectomy

Abstract

Background: Preemptive analgesia is a treatment modality initiated before surgery as a part of multimodal analgesia for optimum treatment of postoperative pain. It accelerates the time to achieve recovery milestones, reduces the length of hospital stay, and improves patient satisfaction. Materials and Methods: It is a prospective, randomized, observational, cross-sectional study. Sixty patients posted for lumbar laminectomy were randomly assigned into two groups to receive tapentadol 100 mg (group A) or tramadol 100 mg (group B) orally 60 min before surgery. Intraoperative fentanyl and isoflurane requirement was recorded. Postoperatively, pain and sedation were assessed at 0, 2, 4, 6, 12, and 24 h; time of first analgesic requirement, paracetamol requirement, time to first rescue analgesia, number of patients requiring rescue analgesia, and morphine requirement were noted. Results: There was a significant reduction in the intraoperative isoflurane (P < 0.05) and fentanyl requirement (P 0.036). The mean postoperative pain scores at all-time points were less in group A compared with group B (P < 0.05), leading to a highly significant reduction in the mean paracetamol dose (P < 0.001) and time to first analgesic requirement (P = 0.047) in group A. The number of patients requiring rescue analgesia (P = 0.0098), time first to rescue analgesia (P = 0.048), and the mean rescue analgesic requirement (morphine) (P = 0.023) were less in group A compared with group B. The incidence of vomiting was significantly higher in group B (P = 0.0385). Conclusion: Tapentadol is more effective preemptive analgesia than tramadol and has a better side effect profile.

Keywords

• analgesia
• laminectomy
• pain
• postoperative
• tapentadol
• tramadol