Analgesia with paracetamol/tramadol vs. paracetamol/codeine in one day-surgery: a randomized open study

Area of Science:

• Pain Management
• Pharmacology
• Surgical Outcomes

Background:

• Postoperative pain management is crucial for patient recovery and satisfaction.
• Fixed-dose combinations of analgesics offer convenient pain relief options.
• Comparing the efficacy and safety of different analgesic combinations is essential for clinical practice.

Purpose of the Study:

• To compare the analgesic efficacy of fixed tramadol/paracetamol (TP 37.5/325 mg) versus codeine/paracetamol (CP 30/500 mg) in patients undergoing day surgery.
• To evaluate the impact of these combinations on quality of life and patient satisfaction post-surgery.

Main Methods:

• A randomized study involving 122 patients undergoing elective day surgeries.
• Patients received either TP 37.5/325 mg or CP 30/500 mg post-surgery, with follow-up dosing for 48 hours.
• Pain was assessed using a Verbal Rating Scale (VRS), with rescue medication (tramadol 50 mg) available for severe pain. Quality of life and patient judgments were also recorded.

Main Results:

• Tramadol/paracetamol (TP) demonstrated significantly higher analgesic efficacy compared to codeine/paracetamol (CP) at 24 hours (VRS: 1.40 vs. 2.52, p < 0.001).
• Fewer patients in the TP group reported adverse events (36% vs. 62%, p < 0.01) and required rescue medication (5.5% vs. 18.2%, p < 0.01).
• Patients treated with TP reported significantly more favorable outcomes, with 54.5% scoring their experience as 'excellent' compared to 16% in the CP group (p < 0.001).

Conclusions:

• Fixed-dose tramadol/paracetamol is a safe and effective option for managing pain after day surgery.
• TP offers superior pain relief, improved safety profile, and enhanced patient satisfaction compared to codeine/paracetamol.
• Optimizing pain management with TP can contribute to reduced hospitalization times and better surgical recovery.