Tramadol for Early Postoperative Analgesia in Abdominal Hysterectomy: Comparison of Different Administration Techniques

Abstract

Introduction:Tramadol is a centrally acting analgesic for control of postoperative pain. This study aimed to compare three different routes of administration of tramadol for early postoperative analgesia in abdominal hysterectomy.Methods:Patients who were scheduled for abdominal hysterectomy with Pfannenstiel incision were divided into three groups according to the routes of administration of tramadol: incisional subcutaneous infiltration (group 1), subcutaneous infiltration plus intravenous administration (group 2), and slow intravenous administration (group 3), by sequential randomization. The analgesic effect was assessed using the revised face pain scale, and side effects such as nausea or hypotension were evaluated at 1, 2, 3, and 4 hours after surgery.Results:A total of 90 cases were evaluated, including 30 cases in each group. In group 3, the pain score at the 1st hour was lower than the others (4.1±2.1 vs.5.2±1.9 and 5.6±2.3; p=0.040). Nausea more often occurred in group 2 at the second hour (33% vs 13% and 13%; p=0.017) and in group 1 at the fourth hour (20% vs 7% and 0; p=0.022). The mean arterial pressure in group 3 was lower at the first and second hours than those in the other groups at the same time points. The mean pulse rates of the groups were similar for each hour.Conclusion:The results of this study showed that intravenous administration of tramadol is more effective for pain control in the first hour.

Keywords

• hysterectomy
• postoperative
• analgesia
• tramadol