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Wound closure tramadol administration has a short-lived analgesic effect

Mohamed Naguib , MB BCH MSc FFARCSI MD^*, Mounir Attia, MB BCH MSc KSUF AB and Abdulhamid H. Samarkandi, MB BS KSUF FFARCSI

^* From the Department of Anesthesia at the University of Iowa College of Medicine and
and King Saud University.

Address correspondence to: Mohamed Naguib MD, University of Iowa College of Medicine, Department of Anesthesia, 200 Hawkins Drive, 6JCP, Iowa City, Iowa 52242-1009 USA. Phone: 319-353-7783; Fax: 319-356-2940; E-mail: mohamed-naguib{at}uiowa.edu

Purpose: To evaluate the effects of tramadol administration at wound closure on postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy.

Methods: In a prospective, randomized, double-blind study 80 patients were allocated into two groups (n = 40 in each) to receive either 200 mg tramadol or placebo iv at the time of wound closure. Postoperatively, all patients received tramadol from a patient-controlled analgesia (PCA) device. Pain, analgesic consumption, vital signs and side effects were recorded postoperatively for 24 hr.

Results: Administration of 200 mg tramadol at the time of wound closure was associated with a short-lived (60 min) reduction in pain scores and PCA consumption compared with placebo. Although the time to first request for analgesia after surgery was longer in patients who received tramadol at wound closure, there was no difference between the two groups with respect to pain scores or to the requirements of postoperative analgesia over the next 23 hr. The cumulative PCA consumption of tramadol in 24 hr was 139.4 ± 108 and 102.4 ± 106 mg in the placebo and tramadol groups, respectively (P = 0.06).

Conclusions: Wound closure administration of 200 mg tramadol had a short-lived (60 min) analgesic effect but did not affect the long-term pain scores or analgesic requirements after laparoscopic cholecystectomy.