Related Experiment Video
Updated: Jun 30, 2025
An Experimental Paradigm for the Prediction of Post-Operative Pain PPOP
Published on: January 27, 2010
Post-operative Pain Control: A Comparison between Bupivacaine and Tramadol Local Wound Infiltration in Children
Efosa Aisien1, Chukwuemeka Ndubuisi Chibuzom2, David Osarumwense Osifo1
1Department of Surgery, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
Insights
This study found that wound infiltration with tramadol (an analgesic) provided comparable pain control to bupivacaine in children undergoing hernia surgery. Tramadol offered a longer duration of pain relief before additional analgesia was needed.
Area of Science:
- Pediatric Surgery
- Pain Management
- Anesthesiology
Background:
- Effective post-operative pain management is crucial for patient satisfaction and hospital stay duration.
- Local wound infiltration with anesthetics like bupivacaine is standard after hernia surgery.
- The use of tramadol for wound infiltration in pediatric patients is less established.
Purpose of the Study:
- To compare the efficacy of post-operative pain control using wound infiltration with bupivacaine versus tramadol.
- To evaluate pain management outcomes in children undergoing herniotomy and orchidopexy.
Main Methods:
- Prospective randomized study of 104 pediatric patients.
- Patients were randomly assigned to receive either bupivacaine (Group A) or tramadol (Group B) wound infiltration.
- Pain was assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) pain score, with time to first and subsequent analgesia recorded.
Main Results:
- Time to first analgesia was significantly longer in the tramadol group (6.11 ± 1.08 hours) compared to the bupivacaine group (6.93 ± 0.80 hours).
- No significant difference was observed in the mean FLACC pain scores at the time of first analgesia between the groups.
- Fewer patients in the tramadol group experienced post-operative vomiting compared to the bupivacaine group.
Conclusions:
- Tramadol wound infiltration is as effective as bupivacaine for post-operative pain control in pediatric herniotomy and orchidopexy.
- Tramadol provides a longer duration of analgesia before rescue medication is required.
- Care should be taken to mitigate the risk of post-operative vomiting with tramadol.
Background:
Post-operative pain control improves patient's satisfaction and affects the period of admission. Local wound infiltration following hernia surgery using xylocaine or bupivacaine has been a common practice. The use of tramadol for such infiltration is relatively new and has not been studied in our environment. This study compared the efficacy of post-operative pain control between Bupivacaine and Tramadol wound infiltration in children who underwent herniotomy and orchidopexy.
Materials And Methods:
This was a prospective randomised study involving 104 patients. A simple random method was used to allocate the study group into two equal groups (A, n = 52 and B, n = 52) using sealed envelopes with contents labelled A or B. Pre- and post-operative respiratory rate, heart rate, and C-reactive protein (CRP) were all recorded. Time to first and subsequent analgesia was determined using face, legs, activity, cry, consolability (FLACC) pain score.
Results:
Fifteen patients in Group A and 18 patients in Group B received each two doses of supplemental analgesia within the first 24 h, ( P = 0.527). Time to first analgesia was significantly different between the two groups, (6.93 ± 0.80 h and 6.11 ± 1.08 h, P = 0.020). The mean FLACC pain score at the time of first analgesia in hours was 4.93 ± 0.59 and 4.72 ± 0.67 for Group A and B, respectively, P = 0.350. The changes in CRP were not different in the two groups, ( P = 0.665). Four patients in Group A, but none in Group B had an episode each of post-operative vomiting.
Conclusion:
Tramadol showed comparable efficacy with bupivacaine in post-operative pain control by wound infiltration in children who had unilateral herniotomy or orchidopexy. Tramadol, however, achieves a longer duration of action before rescue analgesic is required. Caution is necessary to avoid post-operative vomiting.
Related Concept Videos
01:15Opioid Analgesics: Synthetic and Semisynthetic Opioids
01:29Local Anesthetics: Clinical Application as Epidural Anesthesia
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
01:11Local Anesthetics: Clinical Application as Spinal Anesthesia
01:25Analgesia and Pain Management
01:16Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia
One of the advantages of...
01:24Parenteral Anesthetics: Overview