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Along
with pain relief, combination of low-dose tramadol and paracetamol can
decrease the occurrence of nausea and vomiting when used after microdisectomy
surgery.
Postoperative pain is one of the most unpleasant
experiences for a patient undergoing. Developing postoperative pain should be
managed early and aggressively, because severe pain can induce a delay in
discharge and poorer patient satisfaction along with hyperalgesic condition.
The tramadol and paracetamol combination is often used for postoperative pain
management. There is very 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. Its objective was to compare
combinations of Tramadol – Paracetamol for Postoperative
Pain Relief in Elective Single-level Microdisectomy Surgery.
So it had 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. For this main outcome measure used
postoperatively for 4 hours was Visual Analogue Scale pain scores.
This trial involved 94 patients between 18 and 50 years
of age, 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 end.
So the results identified no any notable demographic
difference between groups. None of the patients experienced severe pain
(VAS>6). Even there was no major 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 was reported in 13 patients in
1.5T group, compared to 1T group in 2 patients, which was statistically significant
difference (P=0.004). The
sedation score was similar between groups.
So this study 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.
Journal of Neurosurgical Anesthesiology
Tramadol-Paracetamol Combination for Postoperative Pain Relief in Elective Single-level Microdisectomy Surgery
Dogar, Samie A et al.
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