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Pre-Emptive Tramadol Could Reduce Pain after Ureteroscopic Lithotripsy
Nataša Denčić,Ana Mimić,Jelena Jovičić,Jelena Mirković,Otaš Durutović,Dragica Milenković-Petronić,Nebojša Lađević 연세대학교의과대학 2014 Yonsei medical journal Vol.55 No.5
Purpose: Optimal analgesia in ambulatory urology patients still remains a challenge. The aim of this study was to examine if the pre-emptive use of intravenous tramadol can reduce pain after ureteroscopic lithotripsy in patients diagnosed with unilateral ureteral stones. Materials and Methods: This prospective pilot cohort study included 74 patients diagnosed with unilateral ureteral stones who underwentureteroscopic lithotripsy under general anesthesia in the Urology Clinic at the Clinical Center of Serbia from March to June 2012. All patients were randomly allocatedto two groups: one group (38 patients) received intravenous infusion of tramadol 100 mg in 500 mL 0.9%NaCl one hour before the procedure, while the other group (36 patients) received 500 mL 0.9%NaCl at the same time. Visual analoguescale (VAS) scores were recorded once prior to surgery and two times after the surgery (1 h and 6 h, respectively). The patients were prescribed additional postoperative analgesia (diclofenac 75 mg i.m.) when required. Pre-emptive effectsof tramadol were assessed measuring pain scores, VAS1 and VAS2, intraoperativefentanyl consumption, and postoperative analgesic requirement. Results: The average VAS1 score in the tramadol group was significantly lower than that in the non-tramadol group. The difference in average VAS2 score values between the two groups was not statistically significant; however, there were more patients who experienced severe pain in the non-tramadol group (p<0.01). The number of patients that required postoperative analgesia was not statistically different betweenthe groups. Conclusion: Pre-emptive tramadol did reduce early postoperativepain. The patients who received pre-emptive tramadol were less likely to experiencesevere post-operative pain. Purpose: Optimal analgesia in ambulatory urology patients still remains a challenge. The aim of this study was to examine if the pre-emptive use of intravenous tramadol can reduce pain after ureteroscopic lithotripsy in patients diagnosed with unilateral ureteral stones. Materials and Methods: This prospective pilot cohort study included 74 patients diagnosed with unilateral ureteral stones who underwentureteroscopic lithotripsy under general anesthesia in the Urology Clinic at the Clinical Center of Serbia from March to June 2012. All patients were randomly allocatedto two groups: one group (38 patients) received intravenous infusion of tramadol 100 mg in 500 mL 0.9%NaCl one hour before the procedure, while the other group (36 patients) received 500 mL 0.9%NaCl at the same time. Visual analoguescale (VAS) scores were recorded once prior to surgery and two times after the surgery (1 h and 6 h, respectively). The patients were prescribed additional postoperative analgesia (diclofenac 75 mg i.m.) when required. Pre-emptive effectsof tramadol were assessed measuring pain scores, VAS1 and VAS2, intraoperativefentanyl consumption, and postoperative analgesic requirement. Results: The average VAS1 score in the tramadol group was significantly lower than that in the non-tramadol group. The difference in average VAS2 score values between the two groups was not statistically significant; however, there were more patients who experienced severe pain in the non-tramadol group (p<0.01). The number of patients that required postoperative analgesia was not statistically different betweenthe groups. Conclusion: Pre-emptive tramadol did reduce early postoperativepain. The patients who received pre-emptive tramadol were less likely to experiencesevere post-operative pain.
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