Original Article

Comparison of tramadol use in continuous infusion versus patient controlled analgesia in pain management after laparoscopic cholecystectomy

  • Öner Menteş
  • Ali Harlak
  • Mehmet Eryılmaz
  • Müjdat Balkan
  • Orhan Kozak
  • İsmail Arslan
  • C. Turgut Tufan

Received Date: 12.11.2008 Accepted Date: 11.02.2009 Gulhane Med J 2009;51(1):6-10

Laparoscopic cholecystectomy is the gold standart operation in cholelithiasis. The efficacy, consumption and side effects of tramadol analgesia used either continuous infusion or patient controlled analgesia after laparoscopic cholecystectomy were compared in the present study. Thirty-five patients were recruited in each group constituted prospectively in a randomized manner. Tramadol with an intravenous loading dose of 100 mg and a subsequently continuous infusion of 12.5 mg/h for 24 hours was given in Group I. Patient controlled analgesia was used in Group II, and an intravenous loading dose of 50 mg tramadol with a basal infusion rate of 5 mg/h, a bolus dose of 20 mg, a lock-out time of 30 minute and a maximum dose of 200 mg with 4 hours limited were performed. Visual analog scale scores (0-100), peripheral oxygen saturation, respiratory rate, heart rate and noninvasive arterial blood pressure values were recorded in all patients at 0, 2, 4, 8, 12 and 24 hours. There were no significant differences between the two groups regarding age, gender, weight, ASA status and duration of the operation. There were no significant differences between the two groups on the basis of visual analog scale scores obtained at any of the time measurements. All the patients in Group I were treated with a total tramadol consumption of 400 mg whereas the patients in Group II were treated with a mean tramadol consumption of 164±52.19 (60-200) mg. Tramadol proved its efficacy and safety in the present study. There were no significant differences between the use of the drug in either route regarding efficacy.

Keywords: Patient controlled analgesia, intravenous tramadol, laparoscopic cholecystectomy, postoperative pain