Comparison of continuous infusion and bolus administration of tramadol in postoperative children

Abstract

Objective To appraise the efficacy of tramadol therapy given by continuous infusion and bolus in handling child’s postoperative pain that is mostly inadequate. Methods This was a randomized, single-blinded clinical trial with parallel design. The study was done in the operation room, recov- ery room, pediatric intensive care unit, pediatric surgery, and pedi- atric ward of Cipto Mangunkusumo Hospital, Jakarta, Indonesia. There were sixty patients, 1-12 year-old, with elective operation between January and April 2002. Both groups received bolus of 2mg/kg tramadol as an initial dose. Twenty-nine subjects received continuous infusion of 0.22 mg/kg/h tramadol in 15 minutes after- wards. The other 31 subjects received the same boluses for every 6 hours. Before each tramadol administration, evaluation was done by observer using objective pain scale (OPS) and evaluation sheet that had been tested before the study. The study was done within 24 hours post surgery. Results In the first 6 postoperative hours, mean total dose given by continuous infusion was significantly greater than that given by bolus (p=0.006). On the contrary, mean total dose given within 24 hours by continuous infusion was significantly less than that given by bolus (p=0.037). All subjects showed OPS result of 36 in 0 minute. After that, the result decreased, except in 9 subjects it was still >6 in the 15 th minute. Vomiting was the commonest side effect. Conclusion Continuous infusion of tramadol within 24 hours can be recommended as an analgesic in postoperative children

Keywords

• tramadol
• postoperative children
• continuous infusion
• bolus
• objective pain scale (OPS)