Tramadol-Paracetamol low dose combination shown to have comparable benefits as of high dose combination in postoperative pain relief

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Tramadol-Paracetamol low dose combination shown to have comparable benefits as of high dose combination in postoperative pain relief

Developing postoperative pain should be managed early and aggressively because severe pain can delay the discharge and lead to poorer patient satisfaction along with hyperalgesic condition. Tramadol and paracetamol combination is often used for postoperative pain management. There is limited literature on the use of this combination for vertebral surgery.

A prospective randomized, triple-blind clinical trial was conducted at Aga Khan University Hospital, Karachi to compare combinations of tramadol + paracetamol for postoperative pain relief in elective single-level microdiscectomy surgery.

Thus, there were two groups, group 1T with combination- (1 g paracetamol and a lower dose of tramadol (1 mg/kg:)and group 1.5T. With a combination (1 g paracetamol and a higher dose of tramadol (1.5 mg/kg:) for postoperative pain after microdisectomy surgery. The primary outcome measure used postoperatively for 4 hours was Visual Analogue Scale (VAS) pain scores.

This trial involved 94 patients aged between 18 and 50 years, scheduled for elective single-level microdisectomy and were allocated randomly into 1 of 2 groups. The respective study drug combination was given to patients 20 minutes before the surgery.

Results did not show any notable demographic difference between the groups. None of the patients experienced severe pain (VAS>6). Even there was no significant difference in the mean pain score between groups, which at 4 hours was 2.17 (1.38) in group 1.5T and 1.74 (1.37) in group 1T. The difference was not statistically significant (p=0.14). Nausea and vomiting were reported in 13 patients in the 1.5T group, compared to the 1T group in 2 patients, which was statistically significant difference (p=0.004). The sedation score was similar between the groups.

Therefore, it can be concluded that the combination of low-dose tramadol (1 mg/kg) and paracetamol has comparable analgesia and a decreased incidence of nausea and vomiting compared with the higher dose of tramadol (1.5 mg/kg) and paracetamol combination.

Source:

Journal of Neurosurgical Anesthesiology

Link to the source:

http://journals.lww.com/jnsa/Abstract/2017/04000/Tramadol_Paracetamol_Combination_for_Postoperative.5.aspx

Original title of article:

Tramadol-Paracetamol Combination for Postoperative Pain Relief in Elective Single-level Microdisectomy Surgery

Authors:

Dogar, Samie A et al.

 

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