Comparison of Tramadol and Meperidine for Pain Relief after Tonsillectomy in Children

Abstract

BACKGROUND: Pain is one of the major problem regarding quality of life in children undergoing tonsillectomy. Preemptive analgesia by medicine given before commencement of surgery is a new recommended for relief of pain during and after operation. We compared intra‐and postoperative analgesic and recovery characteristics of tramadol, meperidine with placebo given at induction of anesthesia in 60 children undergoing tonsillectomy with or without adenoidectomy. METHODS: Sixty children (ASA I or II) 4‐7 years old undergoing tonsillectomy with or without adenoidectomy were randomly assigned to receive either saline 0.02 ml/kg (group 1, n = 20), tramadol 2 mg/kg (group 2, n = 20) or meperidine 1 mg/kg (group 3, n = 20) at induction of anesthesia. Thiopental sodium (5 mg/kg) and rocuronium (0.6 mg/kg) were used for the induction of anesthesia, and it was maintained with sevoflurane in N2O/O2 (50/50) via an endotracheal tube. Pain assessment was done by facial pain scale. Agitation scores, time to recovery of spontaneous respiration and the incidence of postoperative nausea and vomiting were assessed. Heart rate and mean arterial pressure were recorded. RESULTS: Facial pain scale scores were increased in group 1 and group 2 at 10 and 20 min after tonsillectomy in recovery room. There was no difference for agitation scores in the three groups. Intraoperative mean arterial pressure (15 min) were found to be higher in group 1 and group 2. The time to recovery of spontaneous respiration was delayed in group 3 compared with group 1 and group 2. The incidence of nausea and vomiting was not statistically differed among groups. CONCLUSION: Meperidine was more effective for pain relief than tramadol, even though recovery of spontaneous respiration was delayed in meperidine group. [By kind permission, KoreaMed, Korean Association of Medical Journal Editors.]