Skip to main content Accessibility help
×
Home
Hostname: page-component-544b6db54f-kbvt8 Total loading time: 0.268 Render date: 2021-10-23T07:56:59.061Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy

Published online by Cambridge University Press:  01 May 2008

S. B. Akinci*
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
B. Ayhan
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
I. O. Aycan
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
B. Tirnaksiz
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of General Surgery, Ankara, Turkey
E. Basgul
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
O. Abbasoglu
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of General Surgery, Ankara, Turkey
U. Aypar
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of Anaesthesiology and Reanimation, Ankara, Turkey
I. Sayek
Affiliation:
Hacettepe UniversitySchool of Medicine, Department of General Surgery, Ankara, Turkey
*
Correspondence to: Seda B. Akinci, Department of Anaesthesiology and Reanimation, Hacettepe University School of Medicine, Sihhiye, Ankara06100, Turkey. E-mail: sedabanu@yahoo.com; Tel: +90 312 3051264; Fax: +90 312 3109600
Get access

Summary

Background and objective

The aim of this study was to compare the postoperative analgesic efficacy of intraperitoneal tramadol with intravenous tramadol or normal saline in patients undergoing laparoscopic cholecystectomy.

Methods

Sixty-one patients undergoing laparoscopic cholecystectomy were randomized to one of three groups in a double-blind manner via coded syringes. All patients received an intravenous and an intraperitoneal injection after installation of the pneumoperitoneum and again before removal of the trocars. In the control group, all injections were with normal saline. In the intravenous tramadol group, patients received intravenous tramadol 100 mg and intraperitoneal saline. In the intraperitoneal tramadol group, patients received intravenous saline and intraperitoneal tramadol 100 mg. All patients had a standard anaesthetic. Postoperative analgesia was with morphine. Postoperatively, numeric pain scores for parietal and visceral pain, 1 h and 24 h morphine consumption, and adverse effects were recorded.

Results

Parietal and visceral pain scores were lowest in the intravenous tramadol group during the first postoperative hour (P < 0.016 compared with control). The delay until the first analgesic administration was longest in the intravenous tramadol group (median 23 min, range 1–45), when compared with the intraperitoneal tramadol group (10, 1–120 min, P = 0.263) or with the control group (1, 1–30 min, P = 0.015). One-hour morphine consumption was significantly lower in the intravenous tramadol group (mean ± SD; 3.4 mg ± 2.5) and in the intraperitoneal tramadol group (4.4 ± 4.3 mg) compared with the control group (6 ± 2 mg) (P = 0.044). There was no difference between the three groups regarding pain scores, morphine consumption and incidence of shoulder pain or adverse effects at 24 h.

Conclusion

Intravenous tramadol provides superior postoperative analgesia in the early postoperative period after laparoscopic cholecystectomy compared with an equivalent dose of tramadol administered intraperitoneally and with normal saline in patients undergoing laparoscopic cholecystectomy.

Type
Original Article
Copyright
Copyright © European Society of Anaesthesiology 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Joris, J, Thiry, E, Paris, P, Weerts, J, Lamy, M. Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine. Anesth Analg 1995; 81: 379384.Google ScholarPubMed
2.Bisgaard, T, Klarskov, B, Bjerregaard Kristiansen, V et al. Multi-regional anesthetic infiltration during laparoscopic cholecystectomy in patients receiving prophylactic multi-modal analgesia: a randomized, double-blinded, placebo-controlled study. Anesth Analg 1999; 89: 10171024.Google ScholarPubMed
3.O’Hanlon, DM, Colbert, S, Ragheb, J, McEntee, GP, Chambers, F, Moriarty, DC. Intraperitoneal Pethidine versus intramuscular Pethidine for the relief of pain after laparoscopic cholecystectomy: randomized trial. World J Surg 2002; 26: 14321436.CrossRefGoogle ScholarPubMed
4.Kehlet, H, Gray, AW, Bonnet, F et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy. Surg Endosc 2005; 19: 13961415.CrossRefGoogle ScholarPubMed
5.Bisgaard, T. Analgesic treatment after laparoscopic cholecystectomy: a critical assessment of the evidence. Anesthesiology 2006; 104: 835846.CrossRefGoogle Scholar
6.Oliva, P, Aurilio, C, Massimo, F et al. The antinociceptive effect of tramadol in the formalin test is mediated by the serotonergic component. Eur J Pharmacol 2002; 445: 179185.CrossRefGoogle ScholarPubMed
7.Robaux, S, Blunt, C, Viel, E et al. Tramadol added to 1.5% mepivacaine for axillary brachial plexus block improves postoperative analgesia dose-dependently. Anesth Analg 2004; 98: 11721177.CrossRefGoogle ScholarPubMed
8.Altunkaya, H, Ozer, Y, Kargi, E, Babuccu, O. Comparison of local anesthetic effects of tramadol with prilocaine for minor surgical procedures. Br J Anaesth 2003; 90: 320322.CrossRefGoogle ScholarPubMed
9.Altunkaya, H, Ozer, Y, Kargi, E, Ozkocak, I et al. The postoperative analgesic effect of tramadol when used as subcutaneous local anesthetic. Anesth Analg 2004; 99: 14611464.CrossRefGoogle ScholarPubMed
10.Akinci, SB, Saricaoglu, F, Atay, OA, Doral, MN, Kanbak, M. Analgesic effect of intra-articular tramadol compared with morphine after arthroscopic knee surgery. Arthroscopy 2005; 21: 10601065.CrossRefGoogle ScholarPubMed
11.Acalovschi, I, Cristea, T, Margarit, S, Gavrus, R. Tramadol added to lidocaine for intravenous regional anesthesia. Anesth Analg 2001; 92: 209214.CrossRefGoogle ScholarPubMed
12.Aldrete, JA, Kroulik, D. A postanesthetic recovery score. Anesth Analg 1970; 49: 924934.CrossRefGoogle ScholarPubMed
13.Mannion, S, O’Callaghan, S, Murphy, DB, Shorten, GD. Tramadol as adjunct to psoas compartment block with levobupivacaine 0.5%: a randomized double-blinded study. Br J Anaesth 2005; 94: 352356.CrossRefGoogle ScholarPubMed
14.Hama, A, Sagen, J. Altered antinociceptive efficacy of tramadol over time in rats with painful peripheral neuropathy. Eur J Pharmacol 2007; 559: 3237.CrossRefGoogle ScholarPubMed
15.Matthiesen, T, Wohrmann, T, Coogan, TP, Uragg, H. The experimental toxicology of tramadol: an overview. Toxicol Lett 1998; 95: 6371.CrossRefGoogle ScholarPubMed
16.Wills, VL, Hunt, DR. Pain after laparoscopic cholecystectomy. Br J Surg 2000; 87: 273284.CrossRefGoogle ScholarPubMed
17.Krzek, J, Starek, M. Quality assessment for tramadol in pharmaceutical preparations with thin layer chromatography and densitometry. Biomed Chromatogr 2004; 18: 589599.CrossRefGoogle ScholarPubMed
18.Parasrampuria, R, Vuppugalia, R, Elliott, K, Mehvar, R. Route-dependent stereoselective pharmacokinetics of tramadol and its active O-demethylated metabolite in rats. Chirality 2007; 19: 190196.CrossRefGoogle ScholarPubMed
19.Barczynski, M, Konturek, A, Herman, RM. Superiority of preemptive analgesia with intraperitoneal instillation of bupivacaine before rather than after the creation of pneumoperitoneum for laparoscopic cholecystectomy: a randomized, double-blind, placebo-controlled study. Surg Endosc 2006; 20: 10881093.CrossRefGoogle ScholarPubMed
20.Naguib, M, Attia, M, Samarkandi, AH. Wound closure tramadol administration has a short-lived analgesic effect. Can J Anaesth 2000; 47: 815818.CrossRefGoogle Scholar
21.Pozos-Guillen, AJ, Aguirre-Banuelos, P, Arellano-Guerrero, A et al. Isobolographic analysis of the dual-site synergism in the antinociceptive response of tramadol in the formalin test in rats. Life Sci 2006; 79: 22752282.CrossRefGoogle ScholarPubMed

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

The postoperative analgesic efficacy of intraperitoneal tramadol compared to normal saline or intravenous tramadol in laparoscopic cholecystectomy
Available formats
×
×

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *