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Analgesic efficacy of tramadol 2 mg kg(-1) for paediatric day-case adenoidectomy
1Department of Surgery and Anaesthesia, Central Hospital of Seinäjoki, Finland.
Insights
Tramadol effectively reduced the need for rescue analgesia in children aged 1-3 years after adenoidectomy. Significantly fewer children receiving tramadol required additional pain medication post-surgery.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Post-operative pain management in children undergoing adenoidectomy is crucial for recovery.
- Optimizing analgesia while minimizing adverse effects is a key clinical challenge.
Purpose of the Study:
- To evaluate the analgesic efficacy of intravenous tramadol in young children (1-3 years) after day-case adenoidectomy.
- To compare the need for rescue analgesia and recovery outcomes between tramadol and placebo groups.
Main Methods:
- A randomized controlled trial involving 80 children aged 1-3 years undergoing adenoidectomy.
- Children received either intravenous tramadol (2 mg/kg) or placebo post-induction of anesthesia.
- Pain and recovery assessments were conducted by a blinded observer, with rescue medication administered as needed.
Main Results:
- Children in the tramadol group required significantly fewer doses of rescue pethidine (P = 0.014).
- Forty-five percent of children receiving tramadol did not require any post-operative analgesia, compared to 15% in the placebo group (P = 0.003).
- Recovery times and adverse event incidence were similar between groups.
Conclusions:
- Intravenous tramadol (2 mg/kg) provides effective post-operative analgesia in children aged 1-3 years after adenoidectomy.
- Tramadol administration significantly reduces the need for supplementary analgesics without increasing adverse effects or delaying recovery.
Abstract:
We studied the analgesic efficacy of tramadol 2 mg kg(-1) for post-operative analgesia after day-case adenoidectomy in children aged 1-3 yr. Eighty children were allocated randomly to receive tramadol 2 mg kg(-1) i.v. or placebo immediately after induction of anaesthesia. Anaesthesia was induced with alfentanil 10 microg kg(-1) and propofol 4 mg kg(-1) followed by mivacurium 0.2 mg kg(-1) for tracheal intubation. Anaesthesia was continued with sevoflurane in nitrous oxide and oxygen. All children were given ibuprofen rectally at approximately 10 mg kg(-1) before the start of surgery. Post-operative pain and recovery assessments were performed by a nurse blinded to the analgesic treatment using the Aldrete recovery score, the pain/discomfort scale and measurement of recovery times. Rescue medication (pethidine in increments of 5 mg i.v.) was administered according to the pain scores. A post-operative questionnaire was used to evaluate the need for analgesia at home up to 24 h after operation. Rescue analgesic at home was rectal or oral ibuprofen 125 mg. Children in the tramadol group required fewer pethidine doses than those in the placebo group (P = 0.014). Forty-five per cent of children receiving tramadol did not require post-operative analgesia at all compared with 15% of children receiving placebo (P = 0.003). Recovery times and the incidence of adverse effects were similar in the two groups in the recovery room and at home. The requirement for rectal ibuprofen at home did not differ between groups.