Recovery following tonsillectomy a comparison between tramadol and morphine for analgesia

The optimal method of intraoperative analgesia for adult tonsillectomy is uncertain. It is important that recovery should be rapid so that the airway is not compromised. Tramadol hydrochloride is an analgesic with mixed -mu and non-opioid activities which has less respiratory depression effects compared to morphine.

We compared the recovery characteristics of patients undergoing tonsillectomy after they were given either morphine or tramadol for intra-operative analgesia. Seventy-nine ASA (American Society of Anesthesiologists) I patients were randomised to receive either tramadol 1.5 mg/kg (n = 44) or morphine 0.1 mg/kg (n = 35). A standard propofol-desflurane based general anaesthetic technique was used.

Patients given tramadol recovered faster compared to morphine as demonstrated by the earlier eye opening at reversal (mean +/- SD, 4.7 +/- 1.5 min versus 5.6 +/- 1.8 min, p = 0.04). There was also significantly less nausea and vomiting in the patients given tramadol as compared to those given morphine (6.8% versus 28.6%, p = 0.01). There were no other clinically important adverse effects in either group.

We conclude that tramadol given for intra-operative analgesia during tonsillectomy results in faster recovery with significantly less nausea and vomiting in the early postoperative period.