Comparison of Local Infiltration of Bupivacaine and Tramadol in Post- Operative Pain Management in Children after Inguinal Herniotomy
Iranian Journal of Pediatric Surgery,
Vol. 4 No. 2 (2018),
Introduction: Adequate pain control is essential in immediate postoperative
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. The objective of this study was to establish the effectiveness of tramadol and bupivacaine for pain control after inguinal herniotomy in children.
Materials and Methods: This randomized controlled trial was conducted at pediatric surgery department, services hospital Lahore over 2 years. Two hundred and eighty four cases randomly divided into two groups B (Bupivacaine) & T (Tramadol). Bupivacaine (dose of 2 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 (WBFPS) at 0,1,2,4 and 8 hours. Both groups experienced side effects.
Results: Age and gender distribution in both groups were comparable. Pain score in both Groups was equal 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.
- Inguinal herniotomy
- Postoperative pain
How to Cite
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, et al: 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, et al: 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, et al: 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, 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, et al: 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, et al: 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, et al: Percutaneous sciatic nerve block with tramadol induces analgesia and motor blockade in two animal pain models. Brazilian Journal of Medical and Biological
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, 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, et al: 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.
- Abstract Viewed: 338 times
- PDF Downloaded: 166 times