A comparison of analgesic efficacy of tramadol and pethidine for management of postoperative pain in children: a randomized, controlled study

Abstract

Prevention of postoperative pain in children is one of the most important objectives of the anesthesiologist. Opioids have been used as an analgesic for postoperative pain in children for many years. Tramadol has both opioid and monoaminergic agonist actions. The aim of the study was to determine if the analgesic potency and occurrence of adverse effects of tramadol differ from pethidine when administered to children. A total of 110 healthy children, aged 2-12 years, scheduled for elective lower abdominal surgery were randomized to receive either pethidine 1 mg/kg (Group I, n = 60) or tramadol 2 mg/kg (Group II, n = 50) for postoperative pain after anesthesia induction. Pain intensity, adverse effects, heart rate, and systolic and diastolic blood pressure were recorded at regular intervals. The mean pain scores on postoperative 24 h were significantly greater with tramadol than with pethidine. Sedation scores, heart rate and systolic and diastolic blood pressure showed no significant differences between the groups. We conclude that pethidine and tramadol are effective in providing analgesia in pediatric patients, but pethidine provided better postoperative analgesia than tramadol. Changes in blood pressure, heart rate and arterial oxygen saturation were minimal and were similar in both drugs.

A comparison of the effect of dexamethasone and pethidine for prevention of shivering after spinal anesthesia in caesarean section: randomization clinical trial

“…Although statistically there was no significant difference between the three groups of Dexamethasone, Pethidine and Normal Saline receivers regarding the reduction of shivering [13][14][15][16] ; because Pethidine is an opioid analgesic, it may interact with another drugs and lead to respiratory depression 16 , and clinical complication rate in Dexamethasone group was lower comparing to Pethidine and Normal Saline groups. Hence, Dexamethasone prophylaxis is recommended.…”

“…On the other hand, Dexamethasone is effective in reducing shivering in patients by regulating immune responses 12 . Most studies showed that Dexamethasone is effective in preventing postoperative shivering with spinal anesthesia 15,16 . The mechanism of post-anesthetic shivering can be established as a thermo-regulatory reaction to low body temperature that occurs during surgeries, which leads to clonic and tonic patterns 3,4,16 .…”

Re: Response to Magos et al.

“…Another RCT in 66 children (age 1-8 years) undergoing adenotonsillectomy for obstructive sleep apnoea found no differences in pain or sedation scores between the two drugs with a lower tendency for desaturation episodes in the tramadol group. 7 The analgesic efficacy and safety of tramadol in children have been confirmed by multiple other studies [6][7][8][9][10][11][12][13][14] in different settings (inpatients and outpatients).…”

Preemptive Analgesia with Paracetamol and Tramadol in Pediatric Adenotonsillectomy

“…Opioids have been used as an analgesic for postoperative pain in children for many years. Tramadol has both opioid and monoaminergic [9,10]. Recently, an i.v.…”