Comparison of Local Infiltration of Bupivacaine and Tramadol in post-operative pain management in children after inguinal herniotomy

asif Iqbal, Naeem Liaqat

Abstract


25

ABSTRACT:

INTRODUCTION: Adequate pain control is essential in immediate post-operative period. Different methods are being used to provide pain management but none of these is completely effective. Regional blocks are becoming more popular then systemic opioids in all age groups due to efficacy and safety of agents used. 

OBJECTIVE: The objective of this study was to determine the effectiveness of tramadol and bupivacaine for post-operative analgesia after inguinal herniotomy in children.

Material & Method: This was a randomized controlled trial conducted at pediatric surgery department, services hospital Lahore over 2years. 284 cases randomly divided in two groups B (Bupivacaine) & T (Tramadol). Bupivacaine (dose of 3 mg/kg) in group B or Tramadol (2mg/kg) in group T was infiltrated in the wound. Postoperatively pain score was measured using Wong-Baker Faces pain scale at 0,1,2,4 and 8 hours. Side effects were noted in both groups.

Results: Age and gender distribution in both the groups were comparable. Pain score noted in both Groups was equal in both groups at 0- hours. however at 1-hour, 2-hour and 4-hour, pain score was slightly more in Group-B. But at 8-hours mean pain score was markedly raised in Group-B as compared to Group-T (3.32 ± 1.42 vs 2.45 ± 1.35). Only complication noted in patients was vomiting which was higher in Group T.

CONCLUSION:

Locally infiltrated Tramadol is a better choice than bupivacaine as a local anesthetic for pain management in children after inguinal herniotomy. Further research is needed to elucidate any benefits it may have in other surgeries.


Keywords


Inguinal herniotomy; Children; Postoperative pain; Bupivacaine; Tramadol; efficacy

Full Text:

PDF

46

References


Reference:

Main C, Watson P. Psychological aspects of pain. Manual therapy. 1999;4(4):203-15.

Walker SM. Pain after surgery in children: clinical recommendations. Current opinion in anaesthesiology. 2015;28(5):570.

Liaqat N, Dar SH. Comparison of single-dose nalbuphine versus tramadol for postoperative pain management in children: a randomized, controlled trial. Korean J Anesthesiol. 2017;70(2):184-7.

Balakrishnan K, Ebenezer V, Dakir A, Kumar S, Prakash D. Bupivacaine versus lignocaine as the choice of locall anesthetic agent for impacted third molar surgery a review. Journal of pharmacy & bioallied sciences. 2015;7(Suppl 1):S230.

Stewart J, Kellett N, Castro D. The central nervous system and cardiovascular effects of levobupivacaine and ropivacaine in healthy volunteers. Anesth Analg. 2003;97(2):412-6, table of contents.

Sahmeddini MA, Azemati S, Motlagh EM. Local Infiltration of Tramadol versus Bupivacaine for Post Cesarean Section Pain Control: A Double-Blind Randomized Study. Iranian journal of medical sciences. 2017;42(3):235.

Desai SN, Badiger SV, Tokur SB, Naik PA. Safety and efficacy of transdermal buprenorphine versus oral tramadol for the treatment of post-operative pain following surgery for fracture neck of femur: A prospective, randomised clinical study. Indian journal of anaesthesia. 2017;61(3):225.

Neagu S, Tudor C, Dincă V, Costea R, Mincă D. Postoperative pain management in elderly patient. Rev Med Chir Soc Med Nat Iasi. 2007;111(1):135-43.

Ahmadi A, Bazargan-Hejazi S, Zadie ZH, Euasobhon P, Ketumarn P, Karbasfrushan A, et al. Pain management in trauma: A review study. Journal of Injury and Violence Research. 2016;8(2):89.

de Almeida MCSe, de Figueiredo Locks G, Brunharo GM, Kauling ALC. Postoperative analgesia: comparing continuous epidural catheter infusion of local anesthetic and opioid and continuous wound catheter infusion of local anesthetic. Brazilian Journal of Anesthesiology. 2011;61(3):293-303.

Garimella V, Cellini C. Postoperative pain control. Clin Colon Rectal Surg. 2013;26(3):191-6.

Nasr YM, Waly SH. Lidocaine-tramadol versus lidocaine-dexmedetomidine for intravenous regional anesthesia. Egyptian Journal of Anaesthesia. 2012;28(1):37-42.

Buccellati C, Sala A, Ballerio R, Bianchi M. Tramadol anti‐inflammatory activity is not related to a direct inhibitory action on prostaglandin endoperoxide synthases. European Journal of Pain. 2000;4(4):413-5.

Sousa A, Ashmawi HA, Costa LS, Posso IdP, Slullitel A. Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models. Brazilian Journal of Medical and Biological Research. 2012;45(2):147-52.

Al AMKW. Post-herniorrhaphy infiltration of tramadol versus bupivacaine for postoperative pain relief: a randomized study. Annals of Saudi medicine. 2008;28(3):165.

Altunkaya H, Ozer Y, Kargi E, Ozkocak I, Hosnuter M, Demirel CB, et al. The postoperative analgesic effect of tramadol when used as subcutaneous local anesthetic. Anesthesia & Analgesia. 2004;99(5):1461-4.

Buhari S, Hashim K, Yong Meng G, Mustapha NM, Gan SH. Subcutaneous administration of tramadol after elective surgery is as effective as intravenous administration in relieving acute pain and inflammation in dogs. The Scientific World Journal. 2012;2012.

Malik AI, Sheikh IA, Shahzad Ahmed Qasmi AA. Comparison of tramadol with bupivacaine as local anaesthetic in postoperative pain control. Journal of Surgery Pakistan (International). 2011;16(1):10-3.

Demiraran Y, Ilce Z, Kocaman B, Bozkurt P. Does tramadol wound infiltration offer an advantage over bupivacaine for postoperative analgesia in children following herniotomy? Pediatric Anesthesia. 2006;16(10):1047-50.

Cekic B, Geze S, Erturk E, Akdogan A, Eroglu A. A comparison of levobupivacaine and levobupivacaine-tramadol combination in bilateral infraorbital nerve block for postoperative analgesia after nasal surgery. Annals of plastic surgery. 2013;70(2):131-4.

Ozcengiz D, Gunduz M, Ozbek H, Isik G. Comparison of caudal morphine and tramadol for postoperative pain control in children undergoing inguinal herniorrhaphy. Pediatric Anesthesia. 2001;11(4):459-64.




DOI: https://doi.org/10.22037/irjps.v4i2.21641

Refbacks