Laffita ZJ, Echazábal MJ, Mora GS, García GE, Buliés DG, Pacheco RMD

Language: Spanish
References: 18
Page:
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ABSTRACT

Introduction: the treatment of postoperative pain is necessary to prevent its unfavorable effects.
Objective: compare the use of peridural tramadol versus morphine for postoperative analgesia in patients with abdominal hysterectomy.
Methods: an observational analytical prospective longitudinal study was conducted with 140 patients who underwent abdominal hysterectomy at Dr. Carlos J. Finlay Central Military Hospital. General orotracheal anesthesia was administered and an epidural catheter used to manage postoperative pain. Patients were randomly distributed into two groups, each with 70 members. One group received analgesia with morphine 4 mg and the other tramadol 100 mg. The variables studied were duration, quality of postoperative analgesia and presence of adverse reactions.
Results: duration of postoperative analgesia was longer in the morphine group (16.7 ± 4.0 h) versus the tramadol group (13.6 ± 4.2 h). Visual analog scale values were higher in the Tramadol group with fewer adverse reactions (38.6 %) versus the Morphine group (55.7 %).
Conclusions: the duration and quality of postoperative analgesia in patients with hysterectomy were greater with the use of peridural morphine, though the use of peridural tramadol is an effective alternative with fewer adverse effects.

REFERENCES

1. Bromage RP. Anestesia epidural. Barcelona: Ed. Salvat; 1984. p. 3-10.

2. Aguilar JL. Analgesia regional postoperatoria. Rev Soc Esp Dolor. 2004;11(1):17-8.

3. Scout LJ, Perry CM. Tramadol. A review of its use in preoperative pain. Drugs. 2000;60:139-76.

4. Gurkan T. Comparison of lumbar epidural Tramadol and lumbar epidural morphine for pain relief after thoracotomy. J Cardiothor Vasc Anesth. 2005;19(4):468-74.

5. Mugabure B, Echaniz E. Fisiología y farmacología clínica de los opioides epidurales e intratecales. Rev Soc Esp Dolor. 2005;12:33-45.

6. Evans H, Steele SM, Nielsen KC, Tucker MS, Klein SM. Peripheral Nerve Blocks and Continuous Catheter Techniques. Anesthetic Clin N Am. 2005;23:141-62.

7. Jeffrey A. Review article. Patient-Controlled Analgesia. Anesth Analg. 2005;101:44-61.

8. Vidal MA, Aragón MC, Torres LM. Opioides como coadyuvantes de la analgesia epidural en pediatría. Rev Soc Esp Dolor. 2005;12(6):348-56.

9. Demiraran Y, Kocaman B, Akman RY. A comparison of the postoperative analgesic efficacy of single-dose epidural tramadol versus morphine in children. Br J Anaesth. 2005 [cited 2008 Jul 10];95(4):510-3. Available from: http://bja.oxfordjournals.org/content/95/4/510.full

10. Richman JM, Wu ChL. Epidural analgesia for postoperative pain. Anesth Clin N Am. 2005;23:125-40.

11. Baraka A, Jabbour S, Ghabash M, Nader A, Khoury G, Sibai A. A comparison of epidural tramadol and epidural morphine for postoperative analgesia. Can J Anesth. 1993;40:308-13.

12. Yaddanapudi LN, Wig J, Singh B, Tewari MK. Comparison of efficacy and side effects of epidural tramadol and morphine in patients undergoing laminectomy: a repeated dose study. Neurol India. 2000;48:398-400.

13. Lázaro C, Caseras X, Torrubia R, Baños JE. Medida del dolor postoperatorio: análisis de la sensibilidad de diversos instrumentos de autovaloración. Rev Esp Anest Reanim. 2003;50:230-6.

14. Chang G, Chen L, Mao J, Opioid Tolerance and Hyperalgesia. Med Clin N Am. 2007;91:199-211.

15. Jeffrey DS, Davis JJ, Johnson KB. Postoperative Care of the Chronic Opioid-Consuming Patient. Anesth Clin N Am. 2005;23:37-48.

16. Bonnet F, Marret E. Postoperative pain management and outcome after surgery. Best Practice & Research. Clin Anaesth. 2007;21(1):99-107.

17. Angst MS, Clark JD. Opioid-induced Hyperalgesia a Qualitative Systematic Review. Anesthesiology. 2006;104:570-87.

18. Kelly L, Nina H. Tramadol: A new centrally acting analgesic. Am J Health Syst Fharm. 1997;54:643-52.