Comparison of morphine and tramadol by patient‐controlled analgesia for postoperative analgesia after tonsillectomy in children

Özalevli, M.; Ünlügenç, H.; Tuncer, Ülkü; Güneş, Yasemin; Özcengiz, Dilek

doi:10.1111/j.1460-9592.2005.01591.x

Cited by 45 publications

(26 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Many studies for post-tonsillectomy pain have low sensitivity and tramadol has been variably reported to be more effective than low-dose paracetamol (Pendeville et al, 2000 Level II), have similar efficacy to morphine (Engelhardt et al, 2003 Level II), and be less effective than pure agonist opioids (Ozer et al, 2003 Level II;Ozalevli et al, 2005 Level III-1) or ketoprofen (Antila et al, 2006 Level II). Further controlled trials are required to determine the role and optimum dose of tramadol in children.…”

Section: Chapter 10mentioning

confidence: 99%

“…Fentanyl PCA has been used safely and effectively following neurosurgery (Chiaretti et al, 2008 Level IV), thoracic surgery (Butkovic et al, 2007 Level III-1) and tonsillectomy (Antila et al, 2006 Level II), and for acute cancer-related pain (Ruggiero et al, 2007 Level IV). In comparison with morphine, tramadol PCA provided minor improvements in time to extubation post cardiac surgery Level II) and reduced nausea post-tonsillectomy but at the cost of higher pain scores (Ozalevli et al, 2005 Level II). Pethidine does not have any advantage over other opioids and neurotoxicity from norpethidine (normeperidine) accumulation has been reported in a healthy adolescent (Kussman & Sethna, 1998).…”

Section: The Pca Prescriptionmentioning

confidence: 99%

See 1 more Smart Citation

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

Objectives: This study aimed to assess analgesia provided by acupuncture, alone or in combination with pharmacotherapy, to patients presenting to emergency departments with acute low back pain, migraine or ankle sprain. Design: A pragmatic, multicentre, randomised, assessor‐blinded, equivalence and non‐inferiority trial of analgesia, comparing acupuncture alone, acupuncture plus pharmacotherapy, and pharmacotherapy alone for alleviating pain in the emergency department. Setting, participants: Patients presenting to emergency departments in one of four tertiary hospitals in Melbourne with acute low back pain, migraine, or ankle sprain, and with a pain score on a 10‐point verbal numerical rating scale (VNRS) of at least 4. Main outcome measures: The primary outcome measure was pain at one hour (T1). Clinically relevant pain relief was defined as achieving a VNRS score below 4, and statistically relevant pain relief as a reduction in VNRS score of greater than 2 units. Results: 1964 patients were assessed between January 2010 and December 2011; 528 patients with acute low back pain (270 patients), migraine (92) or ankle sprain (166) were randomised to acupuncture alone (177 patients), acupuncture plus pharmacotherapy (178) or pharmacotherapy alone (173). Equivalence and non‐inferiority of treatment groups was found overall and for the low back pain and ankle sprain groups in both intention‐to‐treat and per protocol (PP) analyses, except in the PP equivalence testing of the ankle sprain group. 15.6% of patients had clinically relevant pain relief and 36.9% had statistically relevant pain relief at T1; there were no between‐group differences. Conclusion: The effectiveness of acupuncture in providing acute analgesia for patients with back pain and ankle sprain was comparable with that of pharmacotherapy. Acupuncture is a safe and acceptable form of analgesia, but none of the examined therapies provided optimal acute analgesia. More effective options are needed. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12609000989246.

show abstract

Section: Chapter 10mentioning

confidence: 99%

Section: The Pca Prescriptionmentioning

confidence: 99%

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Cohen

Smit

Andrianopoulos³

et al. 2017

Medical Journal of Australia

View full text Add to dashboard Cite

show abstract

“…13 Patients received analgesic study drug until hospital discharge and there were no episodes of respiratory depression described in either group. Ozalevli and colleagues 14 examined pain control differences between the administration of IV tramadol and IV morphine in the form of patient controlled analgesia (PCA) in pediatric patients who underwent T&A. Drugassociated adverse effects in patients receiving either therapy were monitored for 24 hours during PCA administration. There were no reported differences in oxygen saturation in this trial.…”

Section: Resultsmentioning

confidence: 99%

Opioid Use and the Risk of Respiratory Depression and Death in the Pediatric Population

Whittaker

2013

The Journal of Pediatric Pharmacology and Therapeutics

View full text Add to dashboard Cite

BACKGROUND Pediatric patients may be at an increased risk of adverse effects from various medications. Recently, there have been a number of serious adverse events, including several pediatric patients experiencing severe respiratory depression and death as a result of the use of codeine for pain control following tonsillectomy and adenoidectomy. OBJECTIVE To assess the safety of opioid agonists in pediatric patients undergoing operative procedures or have experienced trauma and to evaluate the risk of respiratory depression and death among this population. METHODS PubMed and Medline were searched to identify randomized controlled studies from 1994 to 2012 addressing postsurgery/trauma opioid use in pediatric patients. Relative risks and confidence intervals (CIs) were calculated using data available in clinical trials. RESULTS A total of 16 clinical trials were evaluated for this review. Randomized controlled trials included studies comparing opioids versus non-opioids for a variety of painful conditions. The relative risk of respiratory depression associated with opioid use in 1 trial was 1.63 (95% CI: 0.64-6.13). The remaining 15 trials reviewed described no significant difference in respiratory depression or adverse effects associated with treatment. No deaths were attributed to opioid use in any of these studies. CONCLUSION Opioid-associated respiratory depression was very rare and no deaths were reported in the reviewed studies. These findings under the well-defined conditions of controlled studies may not be the best means of determining overall opioid-associated side effects in pediatric patients. INDEX TERMS

show abstract

“…Although a limited number of individuals were included, this efficacy in tonsillectomy ) after induction of anesthesia were found to be equally effective for decreasing tonsillectomy pain in pediatric patients. When compared with morphine, the analgesic effect of tramadol for posttonsillectomy pain relief given through a patient-controlled analgesia device was lower in the early postoperative period, but the incidence of nausea increased with morphine (6). Although the postoperative analgesic effects of 1 and 2 mg kg −1 tramadol or 0.1 mg kg −1 morphine after induction of anesthesia were found to be comparable, the incidence of nausea and vomiting increased with morphine (75% and 40%, respectively) in pediatric patients undergoing tonsillectomy (7).…”

Section: Discussionmentioning

confidence: 96%

“…Tramadol has been largely investigated to determine the doses of intravenous (i.v.) or peritonsillar infiltration for postoperative pain relief in pediatric patients undergoing adenoidectomy or tonsillectomy (5)(6)(7)(8). Although mucosal application is associated with faster peak plasma concentrations with long-lasting analgesic levels (9), there are limited data about its clinical use in this regard.…”

Section: Introductionmentioning

confidence: 99%

Pre-versus postoperative tramadol instillation: both are effective for decreasing pain and/or agitation in pediatric adenotonsillectomy

Aydın¹,

Apan²,

Kose³

et al. 2013

Turk J Med Sci

View full text Add to dashboard Cite

This research concentrates on the preparation, characterization, and photoluminescence properties of new Co(II), Ni(II), Cu(II), and Zn(II) complexes of N-aminopyrimidine-2-thione. The ligand and metal complexes were characterized by elemental analysis and spectroscopic studies such as IR, UV/Vis, API-ES, NMR, fluorescence, and magnetic susceptibility measurements. The ligand and the resulting metal complexes gave intense emissions ( λmax = 408 nm) upon irradiation by ultraviolet light. The photoluminescence quantum yields and long excited-state lifetimes of the ligand and its complexes were calculated. The ligand had photoluminescence quantum yields of 36% and long excited-state lifetimes of 3.40 ns. The photoluminescence intensities and quantum yields of the metal complexes changed upon complexation with various metals. These novel complexes may be of interest as organic emitting material for electroluminescent devices.

show abstract

Comparison of morphine and tramadol by patient‐controlled analgesia for postoperative analgesia after tonsillectomy in children

Abstract: Intravenous patient-controlled tramadol is an alternative to patient-controlled morphine for postoperative pain relief in children after tonsillectomy. Morphine gave better postoperative pain relief, but was associated with a higher incidence of nausea than tramadol.

Cited by 45 publications

References 25 publications

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

Opioid Use and the Risk of Respiratory Depression and Death in the Pediatric Population

Pre-versus postoperative tramadol instillation: both are effective for decreasing pain and/or agitation in pediatric adenotonsillectomy

Contact Info

Product

Resources

About