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Updated: Oct 15, 2025
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Published on: May 7, 2011
Postoperative Pain Management: Efficacy of Caudal Tramadol in Pediatric Lower Abdominal Surgery: A Randomized
Reza Farahmand Rad1, Farnad Imani1, Azadeh Emami1
1Pain Research Center, Department of Anesthesiology and Pain Medicine, Iran University of Medical Sciences, Tehran, Iran.
Insights
Adding tramadol to caudal ropivacaine enhances pediatric pain control after lower abdominal surgery. This combination provides longer pain relief and reduces analgesic drug needs without increasing complications.
Area of Science:
- Pediatric Anesthesiology
- Pain Management
- Regional Anesthesia
Background:
- Regional anesthesia, including caudal blocks, is used for pediatric post-surgical pain control.
- Limitations exist with current regional techniques.
Purpose of the Study:
- To evaluate the efficacy and safety of caudal tramadol combined with ropivacaine.
- Assessed pain scores and complications in children undergoing lower abdominal surgery.
Main Methods:
- 46 children (3-10 years) received caudal analgesia post-lower abdominal surgery.
- Groups: R (ropivacaine) vs. TR (ropivacaine + tramadol).
- Evaluated pain scores, analgesia duration, drug consumption, hemodynamics, and complications.
Main Results:
- Lower pain scores in the TR group at 6 hours post-surgery (P < 0.05).
- TR group experienced longer analgesia duration and reduced paracetamol use (P < 0.05).
- No significant differences in hemodynamics, operation duration, recovery, or complications between groups.
Conclusions:
- Caudal tramadol combined with ropivacaine effectively improves pain relief in pediatric lower abdominal surgery.
- This combination is safe and does not increase complications.
Background:
One of the methods of pain control after pediatric surgical procedures is regional techniques, including caudal block, despite their limitations.
Objectives:
In this study, the pain score and complications of caudal tramadol were evaluated in pediatrics following lower abdominal surgery.
Methods:
In this study, 46 children aged 3 to 10 years were allocated into two equal groups (R and TR) for performing caudal analgesia after lower abdominal surgery. The injectate contained 0.2% ropivacaine 1 mL/kg in the R group (control group) and tramadol (2 mg/kg) and ropivacaine in the TR group. The pain score, duration of pain relief, amount of paracetamol consumption, hemodynamic alterations, and possible complications at specific times (1, 2, and 6 hours) were evaluated in both groups.
Results:
No considerable difference was observed in the pain score between the groups in the first and second hours (P > 0.05). However, in the sixth hour, the TR group had a significantly lower pain score than the R group (P < 0.05). Compared to the R group, the TR group had a longer period of analgesia and lower consumption of analgesic drugs (P < 0.05). Heart rate and blood pressure differences were not significant between the two groups (P > 0.05). Similarly, the duration of operation and recovery time were not remarkably different between the two groups (P > 0.05). Complications had no apparent differences between these two groups, as well (P > 0.05).
Conclusions:
In this study, the addition of tramadol to caudal ropivacaine in pediatric lower abdominal surgery promoted pain relief without complications.
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