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[Tramadol infusion for pain therapy following bladder exstrophy surgery in pediatric wards]
N Griessinger1, W Rösch, G Schott
1Klinik für Anästhesiologie, Universität Erlangen-Nürnberg.
Insights
Continuous tramadol administration effectively managed pain in 17 children after major urological surgery. This safe and simple method reduced pain scores significantly with minimal side effects like nausea and vomiting.
Area of Science:
- Pediatric Urology
- Pain Management
- Pharmacology
Background:
- Major urological surgeries like augmentation cystoplasty and exstrophy reconstruction in children often require effective postoperative pain management.
- Continuous intravenous opioid administration is a common strategy, but specific data on tramadol in this pediatric population is limited.
Purpose of the Study:
- To evaluate the efficacy and safety of continuous tramadol administration for pain control in children undergoing major urological reconstructive surgery.
- To assess pain scores, opioid consumption, and adverse events associated with this treatment regimen.
Main Methods:
- A prospective study involving 17 pediatric patients (mean age 7.1 years) receiving continuous tramadol infusion post-surgery.
- Pain was assessed using a ten-step scale, and tramadol dosage was adjusted by nursing staff.
- Oxygen saturation levels and adverse events (nausea, vomiting, pruritus, sedation) were monitored.
Main Results:
- Median pain scores decreased from 5 pre-treatment to 0.5 by day 5.
- Mean tramadol consumption decreased from 0.21 mg/kg/h on day 1 to 0.08 mg/kg/h on day 4.
- Adverse events were minimal, with nausea/vomiting occurring in 4.7% of treatment days; pruritus and extreme sedation were absent.
Conclusions:
- Continuous tramadol infusion is a safe and effective method for managing postoperative pain in children following major urological reconstructive procedures.
- The procedure is simple to administer and associated with a low incidence of significant adverse effects.
- This approach offers a viable pain management option in pediatric urological surgery.
Abstract:
We investigated in 17 children (mean 7.1 years) the continuous administration of tramadol following augmentation cystoplasty or exstrophy reconstruction. Mean duration of the tramadol administration on the pediatric ward was 3.8 +/- 1.1 days (initial dosage 0.25 mg/kg/per hour, dose adjustment by the nursing staff). Mean tramadol consumption was 0.21 mg/kg/h on day 1 and was reduced to 0.08 mg/kg/per hour on day 4. Median pain score (assessed with ten-step scales) was 5 before treatment and between 2.5 (day 1) and 0.5 (day 5) during therapy. Lowest oxygen saturations (mean) ranged from 93.8% to 95.2%. Three patients (17.6%) suffered from nausea/vomiting on 3 of 64 treatment days (4.7%). Pruritus and extreme sedation did not occur. The continuous administration of tramadol is a simple and safe procedure following major urological surgery in children.