Injectable Tramadol vs Diclofenac for Postoperative Pain Management in Laparoscopic Cholecystectomy Surgery: A Comparative Prospective Study

Abstract

Introduction: Laparoscopic management of gallstones is considered as the gold standard treatment nowadays and is the most common surgery done in the present scenario. Postoperative pain remains one of the most common complaints after laparoscopic cholecystectomy and should be managed with proper analgesia with minimal side effects.Aim: To compare the efficacy of injectable tramadol and diclofenac in the pain management after laparoscopic cholecystectomy surgery. Materials and methods: A randomized prospective study was done at Maharishi Markandeshwar College of Medical Science & Research in the Department of General Surgery on 50 patients undergoing laparoscopic surgery between December 2016 and December 2017. Postoperative analgesic is decided randomly with the help of dice. Pain is measured on visual analog scale (VAS) on 6, 12, 18, and 24 hours.Results: A total of 50 patients, divided in two groups I and II, were taken in this study from December 2016 to December 2017 who underwent laparoscopic cholecystectomy. Group I was given injection diclofenac and group II was given injection tramadol postoperatively for pain management 8 hourly. Both I and II groups were matched in all respect with age, weight, and operative time. Pain relief after diclofenac first dose postoperatively in 8 hours was seen in 7 patients, in 9 to 16 hours in 12 patients, and 17 to 24 hours in 18 patients. Pain relief after tramadol first dose postoperatively in 8 hours was seen in 16 patients, in 9 to 16 hours in 21 patients, and 17 to 24 hours in 25 patients. Postoperatively, patients complained of nausea and vomiting. Group II having tramadol infusion complained of higher incidence of nausea and vomiting as compared with group I having diclofenac for pain management. Conclusion:Pain after laparoscopic cholecystectomy is a common complaint encountered. Good analgesia should be given to patients but should have minimal side effects. It was concluded from our study that tramadol in injectable form is WJOLS