Comparison of the analgesic profile and side effects of tramadol vs pethidine, following urologoical surgery

Abstract: The optimization of pain management following surgery with minimal side effects, is one the major goals of surgical and medical teams. In this randomized double blind study, sixty ASA (American Society of Anesthesiologist) class I or II patients, undergoing urological surgery, were assessed to receive either pethidine or tramadol using a standard method for general anesthesia. Pain intensity was assessed by verbal rating, through a 4-step scaling system. Results of this investigation have revealed that the mean total drug administered in tramadol group were 244.53 + 56.95 mg and in pethidine group 176.78+42.99 mg respectively. There were no significant differences in analgesic effect, observed in either group during early hours following surgery, but after 8,12 and 16 hours significant differences were observed. Analgesic properties of tramadol were almost comparable with pethidine nevertheless; pethidine was superior in some extent. No significant differences in patient’s PaO2 were found, but PaCO2 at 1 and 4 hours after surgery had a greater retention in pethidine group. (P<0.001). There was a significant reduction in respiratory rate in pethidine group at 4,8,12 and 16 hours following surgery, compared with tramadol group (P<0.001). Incidence of dizziness was greater in patients who received pethidine (P<0.001), and sweating was higher in tramadol group (P<0.01). Also there was a greater need for metoclopramide to overcome nausea in tramadol group (P<0.05). Results of this study may suggest that tramadol could be considered as a safe and effective analgesic, following urological surgery as compared with pethidine