According to this study, administration of vitamin C 3 g IV intraoperative reduced postoperative pain without increased side-effects in patients undergoing UPPP and tonsillectomy.

The purpose of this study was to evaluate the effect of preoperative administration of duloxetine on postoperative pain after laparoscopic myomectomy. In this double-blind clinical trial study, 57 patients aged 18-55 years with ASA I or II undergoing laparoscopic myomectomy involved. The case group received oral duloxetine 60 mg, and the control group received placebo 2 hours before the surgery. Pain scores, total analgesic consumption during 24 hours, recovery discharging time, nausea, vomiting, dizziness, and hemodynamic changes were recorded and compared between two groups. The pain severity was significantly lower in the case group at 2, 12, and 24 hours after the operation (P<0.05). There were no significant differences in dizziness, nausea, vomiting, systolic and diastolic blood pressure, and heart rate of patients between two groups before the surgery, 5 and 30 minutes after the induction, and after the recovery. Duloxetine administration prior to laparoscopic surgery myomectomy can reduce postoperative pain without inducing side effects in patients.

The aim of the study was to compare the effects of peritonsillar infiltration of tramadol before and after the surgery on post-tonsillectomy pain. In this double-blinded clinical trial study, 80 children aged 5-12 years old with ASA (American Society of Anesthesiologists) class I or II undergoing tonsillectomy involved. In group A (n = 40), after anesthesia induction and before starting the surgery, tramadol 2 mg/kg diluted in normal saline up to 2 cc total volume was injected into the tensile bed by the anesthesiologist using a 25 gauge needle. Surgery began 3 min later and the tonsils were removed using the sharp dissection method. In children of group B (n = 40), anesthesia induction was performed. When surgery was completed, tramadol 2 mg/kg diluted in normal saline up to 2 cc total volume was injected at the site of removing each tonsil using a 25 gauge needle by the anesthesiologist. Using the CHEOPS (Children's Hospital of Eastern Ontario Pain Scale) Scale, pain recorded at different times. Patient sedation was recorded using the RAMSAY Sedation Scale. All the data were analyzed using SPSS 17 statistical software. Two groups significantly felt different pain intensities at different times following the surgery. At the three times, the mean sedation score in the group receiving tramadol infiltration before surgery was a little higher compared to the other group, but this difference was not significant (p > 0.05). As for the relative frequency of nausea and vomiting, the difference was not significant (p = 0.793). Request for analgesics between the groups was not significant (p = 0.556). The mean time of the first feeding after the surgery was not significant between the groups (p = 0.062). Surgical duration was almost the same for both groups (p > 0.05). Systolic blood pressures (before surgery, before extubation, and after extubation) were statistically the same in both groups (p < 0.05). Furthermore, systolic blood pressures 10, 15, and 30 min after entry into the recovery room were the same in both groups. We concluded that peritonsillar infiltration of tramadol before surgery controlled postoperative pain better from 8 h after the surgery to hospital discharge (late effect), but that local infiltration of tramadol after surgery controlled postoperative pain better up to 2 h after the operation (early effect).

800 mg oral gabapentin given 90 min before a procedure attenuates the rise of diastolic blood pressure and mean arterial blood pressure in the first 15 min after microlaryngoscopy surgery, but has no effect on systolic blood pressure or heart rate.

Introduction The present study was attempted to evaluate the effect of perianal infiltration of tramadol on postoperative pain in patients undergoing hemorrhoidectomy. Method This double-blind clinical trial study was carried out on 90 patients with grade 3 and 4 hemorrhoids undergoing hemorrhoidectomy. Patients were randomly assigned into 3 groups of control or bupivacaine or tramadol. Before the surgery, perianal infiltration of .25% bupivacaine or tramadol or normal saline was prescribed to each group, respectively. Data on pain severity (based on the visual analog scale (VAS), the duration of surgery, sedation score, pain at the first defecation, first request time for additional analgesia, nausea and vomiting, and analgesic intakes) were evaluated and analyzed. Results Duration of surgery was almost similar in all 3 groups ( P = .974). The results showed a significant difference in pain score between 3 groups ( P ≤.05) at all times after the surgery. In addition, the means of sedation scores ( P = .03), pain score at the first defecation ( P = .001), the time to first analgesic request ( P = .001), and ketorolac administration times ( P = .01) were significantly different between 3 groups. Finally, no complication was reported regarding postoperative nausea and vomiting. Conclusion Given the notable efficacy of tramadol in reducing pain after hemorrhoidectomy and its minor side effects, this medication is suggested as an effective topical anesthetic to decrease pain after hemorrhoidectomy.