Can Intraperitoneal Tramadol decrease Pain in Patients undergoing Laparoscopic Cholecystectomy in Postoperative Period? A Randomized Controlled Trial

Abstract

Aim:To evaluate analgesic effect of intraperitoneal tramadol in patients undergoing laparoscopic cholecystectomy. Settings and design:Prospective, double blind, randomized study. Materials and methods:Hundred patients undergoing laparoscopic cholecystectomy were randomized into two groups, I and II, of 50 each: Group I received intraperitoneal tramadol 100 mg (diluted in 20 mL of distilled water) immediately after induction of pneumoperitoneum and just before removal of trocars. Similarly, group II received 20 mL of intraperitoneal normal saline. All patients had a standard anesthetic. Rescue analgesia was with diclofenac sodium. Postoperatively, visual analog scale, 1 and 24 hours diclofenac consumption, postoperative hospital course, and adverse effects were recorded. Statistical analysis: Student's t-test and Epi Info statistical software were used for statistical analysis.Results: Pain intensity is significantly less in group I than in group II in first 4 hours, while requirement of analgesic postoperatively is significantly less in group I than in group II in first 8 hours except at 30 and 60 minutes. Better control of blood pressure and respiratory rate was seen in group I in first 4 hours. There was no significant difference between two groups regarding postoperative hospital course and incidence of adverse effect. Conclusion:Intraperitoneally, tramadol provides superior postoperative analgesia in the early postoperative period after laparoscopic cholecystectomy compared with normal saline in patients undergoing laparoscopic cholecystectomy.