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[Comparative study of the effect of two analgesic techniques in postoperative pain control in pediatric surgery]
E M Castilla Parrilla1, B Gironés Camarasa2, C García Dueñas1
1Servicio de Cirugía Pediátrica. Complejo Hospitalario Virgen de las Nieves. Granada.
Insights
Paracetamol plus metamizol and tramadol offer comparable pain relief after pediatric surgery. However, tramadol was associated with significantly more side effects, including vomiting.
Area of Science:
- Anesthesiology
- Pediatric Surgery
- Pharmacology
Background:
- Effective postoperative pain management is crucial in pediatric ambulatory surgery.
- Opioid and non-opioid analgesics are commonly used for pain control.
- Evaluating the comparative efficacy and safety of different analgesic combinations is essential.
Purpose of the Study:
- To compare the analgesic efficacy of paracetamol + metamizol versus tramadol in children undergoing abdominal ambulatory surgery.
- To assess pain intensity, need for rescue analgesia, and side effects in both groups.
Main Methods:
- A prospective, randomized, double-blind study involving 60 pediatric patients (3-8 years).
- Patients received either paracetamol + metamizol or tramadol preoperatively.
- Pain was assessed using the Wong-Baker scale, and side effects were monitored hourly postoperatively.
Main Results:
- Analgesia duration was similar between the paracetamol + metamizol group (202 min) and the tramadol group (215 min) (p=0.233).
- Pain scores on the Wong-Baker scale did not differ significantly between groups.
- Significantly higher overall side effects (p<0.05) were observed in the tramadol group, with 5 cases of vomiting compared to none in the other group.
Conclusions:
- Both paracetamol + metamizol and tramadol provide adequate postoperative pain control in pediatric abdominal ambulatory surgery.
- The combination of paracetamol + metamizol may be preferred due to a lower incidence of side effects compared to tramadol.
Objective:
The study purpose was to evaluate the analgesic efficacy of the association of paracetamol + metamizol versus tramadol in pediatric surgery.
Methods:
A prospective, randomized and double-blinded study of 60 patients between 3 and 8 years, undergoing abdominal surgery in the ambulatory unit. Patients were divided into 2 groups who received paracetamol plus metamizol (Group I) or tramadol (Group II), prior to the end of the procedure. The anesthetic technique in all cases consisted of general anesthesia balanced. The study compared the pain intensity according to the Wong-Baker scale, the need of rescue analgesia, and the side effects every hour in the postoperative period. The statistical analysis was performed using the chi-square test and T-Student test.
Results:
The analgesia time for Group I was 202 ± 25 minutes and 215 ± 17 minutes for Group II without statistical significance. There was no significant differences (p= 0.233) in the pain scores; only 3 children in the first group had more than 4 points on the Wong-Baker scale versus 5 children in the tramadol group. The overall side effects were significantly higher (p< 0.05) in Group II, 5 patients presented vomiting compared to no child in Group I. The average dose of morphine chloride was 0.6 ± 0.2 mg.
Conclusions:
Both techniques provide adequate pain control in the postoperative period of abdominal ambulatory surgery in pediatric patients. However, children treated with tramadol presented a greater number of side effects compared to the NSAIDs group.
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