The effect of local tramadol injection in post appendectomy pain

Background : It has been demonstrated that tramadol, asemisynthetic opioid, is an effective analgesic with systemic (central) and local (peripheral) anesthetic effects. The aim of this study was to compare the post-operative anesthetic effect of subcutaneous wound infiltration of tramadol with normal saline as placebo in the incision wounds after appendectomy and measuring the average need to petidine during the next 24 hours after the appendectomy.

  Materials and Method : This double blind study was carried out on 60 patients over 15 years old. Patients were randomly divided in two equal groups. At the end of procedure after repairing fascia 100mg of tramadol that was diluted with water for injection up to 10 cc in one syringe or 10 cc of normal saline in another syringe was infiltrated subcutaneously by surgeon before suturing the skin. The intensity of pain (NRS) was recorded in the recovery room, after 6 and 24 hours post-operation as well as total amount of administered petidine in the same period. At the end of study the intensity of pain in the mentioned times and the average use of petidine compared in two groups.

  Results : A significant difference was noted in the severity of pain between two groups in recovery time, 6 and 24 hours afetr operation that was lower in tramadol group (p<0.0001). Also the average use of petidine was significantly lower in tramadol group in 24 hours (p<0.05). The average severity of pain by NRS in recovery was 5.36 for control (N) and 3.08 for tramadol (T) groups and after 6 hours it was 5.36 for (N) and 3.36 for (T) and after 24 hours reached to 3.08 for (N) and 2.08 for (T) and the average number of injected 25mg ampoules of petidine was 1.56 in (N) and 0.76 in (T).

  Conclusion : Local wound infiltration of tramadol is a good choice for reduction of post appendectomy pain and decreasing need for high potent opioid analgesics