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Tramadol wound infiltration is not different from intravenous tramadol in children: a randomized controlled trial
Ana Laura Albertoni Giraldes1, Angela Maria Sousa2, Alexandre Slullitel3
1Department of Anesthesia, Surgery Division, Pediatric Anesthesia Unit, Federal University of São Paulo, São Paulo, Brazil.
Insights
Tramadol effectively reduced postoperative pain in children, whether administered intravenously or infiltrated into the wound. Both methods showed similar outcomes for pain, nausea, and vomiting following minor surgery.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Pharmacology
Background:
- Tramadol exhibits potential local anesthetic properties.
- Effective pain management in pediatric surgery is crucial for recovery.
Purpose of the Study:
- To compare the efficacy of wound infiltration versus intravenous administration of tramadol for pain control in children undergoing minor surgical procedures.
Main Methods:
- A randomized, double-blind, controlled trial involving 40 pediatric patients (ASA physical status I or II) undergoing elective inguinal hernia repair.
- Patients received either intravenous tramadol or subcutaneous wound infiltration with tramadol.
- Postoperative pain, nausea, vomiting, and rescue medication requirements were assessed in the postanesthesia care unit.
Main Results:
- No statistically significant difference in pain scores between the intravenous tramadol and wound infiltration groups.
- Time to first rescue medication was not significantly shorter in the intravenous group.
- Total consumption of rescue analgesics (morphine and dipyrone) was similar across both groups.
Conclusions:
- Tramadol is an effective analgesic for pediatric postoperative pain, regardless of administration route (intravenous vs. wound infiltration).
- Both methods demonstrated comparable safety and efficacy profiles regarding pain intensity, nausea, vomiting, and somnolence.
Study Objective:
The purpose of this trial was to assess if tramadol wound infiltration is superior to intravenous (IV) tramadol after minor surgical procedures in children because tramadol seems to have local anesthetic-like effect.
Design:
Randomized double-blind controlled trial.
Setting:
Postanesthesia care unit.
Patients:
Forty children, American Society of Anesthesiologists physical status I or II, scheduled to elective inguinal hernia repair.
Interventions:
Children were randomly distributed in 1 of 2 groups: IV tramadol (group 1) or subcutaneous infiltration with tramadol (group 2). At the end of the surgery, group 1 received 2 mg/kg tramadol (3 mL) by IV route and 3-mL saline into the surgical wound; group 2 received 2 mg/kg tramadol (3 mL) into the surgical wound and 3-mL saline by IV route.
Measurements:
In the postanesthesia care unit, patients were evaluated for pain intensity, nausea and vomiting, time to first rescue medication, and total rescue morphine and dipyrone consumption.
Main Results:
Pain scores measured during the postanesthesia recovery time were similar between groups. Time to first rescue medication was shorter, but not statistically significant in the IV group. The total dose of rescue morphine and dipyrone was also similar between groups.
Conclusions:
We concluded that tramadol was effective in reducing postoperative pain in children, and there was no difference in pain intensity, nausea and vomiting, or somnolence regarding IV route or wound infiltration.
