A comparison of the postoperative analgesic efficacy of single-dose epidural tramadol versus morphine in children

• Published in: British journal of anaesthesia : BJA Vol. 95; no. 4; pp. 510 - 513
• Main Authors: Demiraran, Y., Kocaman, B., Akman, R.Y.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.10.2005; Oxford University Press; Oxford Publishing Limited (England)
• Subjects: Adolescent; anaesthesia; anaesthesia, paediatric; Analgesia, Epidural - methods; analgesic techniques; analgesic techniques, epidural; analgesics opioid; analgesics opioid, morphine; Analgesics, Opioid - adverse effects; Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Child; Double-Blind Method; Drug Eruptions - etiology; epidural; Humans; Male; Medical sciences; morphine; Morphine - adverse effects; paediatric; Pain, Postoperative - prevention & control; Postoperative Complications; Postoperative Nausea and Vomiting - chemically induced; Tramadol - adverse effects; Urologic Surgical Procedures, Male; analgesic techniques, epidural; analgesics opioid, morphine; anaesthesia, paediatric; Allergy; Systolic pressure; Skin disease; Opiates; Morphine; Pruritus; Sedation; Narcotic analgesic; Incidence; Extradural; epidural; analgesics opioid; Paracetamol; Pain; Surgery; Tramadol; Anesthesia; Blood pressure; Respiratory depression; Child; paediatric; analgesic techniques; Human; Postoperative; Immunopathology; Antimigrainous agent; Single dose; Oral administration; Heart rate; Analgesia; Decubitus; Antipyretic; Intubation; Preoperative; Respiration; Comparative study; anaesthesia
• ISSN: 0007-0912; 1471-6771
• DOI: 10.1093/bja/aei214

The aim of this study was to compare epidural administration of single-dose tramadol with morphine in children undergoing urological surgery with respect to preoperative haemodynamic effects, postoperative analgesia and side-effects. Eighty children aged between 7 and 14 undergoing urological surgery were included in the study. After intubation, in the lateral decubitus position, a single dose of morphine 0.1 mg kg−1 in isotonic saline 0.2 ml kg−1 (morphine group) and tramadol 2 mg kg−1 in isotonic saline 0.2 ml kg−1 (tramadol group) was administered epidurally. During the 24-h postoperative period, heart rate, systolic blood pressure, respiration rate, pain score and sedation level of the patients were monitored. A modified objective pain score of 3 or lower was accepted as an indicator of inadequate analgesia and these patients were given 20 acetaminophen mg kg−1 rectally or orally. Time to first analgesia was noted. Sedation level was evaluated with a four-point sedation scale. In the postoperative period, pain scores and the average time for analgesic requirement were similar in the two groups. However, the incidences of allergic rash, itching, sedation and respiratory depression and sedation score were greater in the morphine group than in the tramadol group. Greater epidural use of tramadol may be preferred to morphine for postoperative analgesia under these circumstances.