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PAIN MEDICINE

The Postoperative Analgesic Effect of Tramadol When Used as Subcutaneous Local Anesthetic

Hanife Altunkaya, MD^*, Yetkin Ozer, MD^*, Eksal Kargi, MD, Isil Ozkocak, MD^*, Mübin Hosnuter, MD, Cengiz Bekir Demirel, MD^*, and Orhan Babuccu, MD

Departments of *Anesthesiology and Plastic and Reconstructive Surgery, Zonguldak Karaelmas University, School of Medicine, Kozlu/Zonguldak, Turkey

Address correspondence and reprint requests to Hanife Altunkaya, MD, Ev-Ko Konutlari F-66 No: 8, 67600 Kozlu/Zonguldak, Turkey. Address e-mail to haltunkaya{at}hotmail.com

Recently, it has been shown that tramadol was an effective local anesthetic in minor surgery. In this study, its efficacy for relieving postoperative pain was evaluated. Forty patients undergoing minor surgery (lipoma excision and scar revision) under local anesthesia were included. The patients were randomly allocated into two groups: In group T (n = 20), 2 mg/kg tramadol, and in group L (n = 20), 1 mg/kg lidocaine were given subcutaneously. In both groups, the injection volume was 5 mL containing 1/200,000 adrenalin. The degree of the erythema, burning sensation, and pain at the injection site were recorded. Incision response, which is a degree of the pain sensation during incision, was recorded and graded with the visual analog scale (VAS) 0–10. After incision, VAS values were recorded at 15-min intervals. When the VAS score of the pain during surgery exceeded 4, an additional 0.5 mg/kg of the study drug was injected and this dosage was added to the total amount. Patients were discharged on the same day. Subjects with VAS 4 were advised to take paracetamol as needed. No side effects were recorded in either group except for 1 patient complaining of nausea in group T at the 30th min of operation. After 24 h, patients were called and the time of first analgesic use and total analgesic dose taken during the postoperative period were recorded. During the 24 postoperative hours, 18 of 20 (90%) subjects did not need any type of analgesia in group T, whereas this number was 10 (50%) in group L (P < 0.05). The time span before taking first analgesic medication was longer (4.9 ± 0.3 h) in group T than that of group L (4.4 ± 0.7 h) (P < 0.05). We propose that tramadol can be used as an alternative drug to lidocaine for minor surgeries because of its ability to decrease the demand for postoperative analgesia.

IMPLICATIONS: The local anesthetic and postoperative analgesic effect of tramadol were compared with that of lidocaine for minor surgery performed using local anesthesia. Tramadol may be a good choice for minor surgery because of its sufficient local anesthetic and analgesic effects.

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