Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine
Authors: Engelhardt T.1; Steel E.1; Johnston G.1; Veitch D.Y.1
Source: Paediatric Anaesthesia, Volume 13, Number 3, March 2003 , pp. 249-252(4)
Publisher: Blackwell Publishing
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Abstract:
Summary Background: Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK. Methods: We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1 mg·kg-1), tramadol (1 mg·kg-1) and tramadol (2 mg·kg-1) groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 mg·kg-1) rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge. Results: There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P=0.03) compared with both tramadol groups. Conclusions: Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.Keywords: tramadol; morphine; adenotonsillectomy; pain relief; children
Document Type: Research article
DOI: 10.1046/j.1460-9592.2003.00983.x
Affiliations: 1: Royal Aberdeen Children's Hospital, Aberdeen, UK
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