Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine

Thomas Engelhardt, E. Steel, G. Johnston, D. Y. Veitch

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    Abstract

    Background: Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK.
    Methods: We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mg.kg(-1)), tramadol (1 mg.kg(-1)) and tramadol (2 mg.kg(-1)) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mg.kg(-1)) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge.
    Results: There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P =0.03) compared with both tramadol groups.
    Conclusions: Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.

    Original languageEnglish
    Pages (from-to)249-252
    Number of pages3
    JournalPediatric Anesthesia
    Volume13
    Issue number3
    DOIs
    Publication statusPublished - Mar 2003

    Keywords

    • tramadol
    • morphine
    • adenotonsillectomy
    • pain relief
    • children
    • double blind
    • analgesia
    • anesthesia
    • placebo
    • nausia
    • combination
    • paracetamol
    • diclofenac
    • NALBUPHINE

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