Comparative Evaluation of Tramadol Wound Infiltration over Bupivacaine for Postoperative Analgesia in Children Undergoing Inguinal Herniotomy and Orchidopexy

Abstract

BACKGROUND: Recent clinical studies have demonstrated that children experience a similar severity of post operative pain as adults and that even preterm infants demonstrate alterations in heart rate, blood pressure and oxygen saturation in response to pain.

OBJECTIVE: To study the advantage of tramadol wound infiltration over bupivacaine on post operative pain relief in children following inguinal herniotomy and orchiodopexy

METHODS: In this prospective single blinded randomized controlled study, 705 children aged between 1–7 years undergoing elective repair of unilateral inguinal hernia and orchiodopexy were randomly divided into 3 groups of 25 each. Group A (Tramadol) à wound infiltration with 2mg/Kg Tramadol in 0.2ml/Kg saline, Group B (Bupivacaine) à wound infiltration with 0.2ml/Kg of 0.25% of Bupivacaine and Group C (Tramadol i/m) à 2mg/Kg tramadol intra muscularly 20 minutes before the end of surgery. Children were assessed post-anesthesia for pain score and discharged from Post Anesthesia Care Unit when they achieved a score of 10.

RESULTS: Group A had lower pain scores than group B and C for the first 24 hours in the postoperative period. The other two parameters pulse rate and respiratory rate were also lower in group A. Moreover use of rescue analgesia was significantly lower in group A.

CONCLUSION: Wound infiltration with tramadol is a good choice for post operative analgesia in children undergoing inguinal herniotomy and orchidopexy. JMS 2011;14(2):52-55