Comparison of Continuous Infusion of Intravenous Tramadol and Fentanyl on Postoperative Analgesia in Cardiac Surgery
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- Category: Vol. 77, June 2009
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Comparison of Continuous Infusion of Intravenous Tramadol and Fentanyl on Postoperative Analgesia in Cardiac Surgery,MOHAMAD S. ALI, MOHAMAD G. ABD EL-RAHEEM, HESHAM A. MOHAMAD, ABD EL-RADY S. IBRAHEEM, MOHAMAD A. HASSAN, KAWTHER H.M. MOHAMAD
Abstract
Background: Adequate postoperative analgesia can help in decreasing patient discomfort and in reducing hospital stay after cardiac surgery. This study was designed to compare the effect of tramadol and fentanyl infusion on post operative pain relief after cardiac surgery.
Methods: Forty one patients undergoing open heart surgery were randomly assigned into two groups; Fentanyl group (21 patients) and Tramadol group (20 patients). Both groups received the same anaesthetic technique. Infusion of both drugs started directly after the end of cardiopulmonary bypass and continued for 48 hours after surgery. Fentanyl was given at a dose of 0.5-1mg.kg-1.h-1 by continuous infusion for 48 hours, while Tramadol was infused at a dose of 0.1-0.2 mg.kg-1.h-1. In addition, both groups received 1 gm rectal paracetamol every six hours.
Patients were assessed for the analgesic efficacy by 11- point verbal rating scale (VRS), sedation by Ramsay sedation scale and patients’ satisfaction with analgesia using a 100- point verbal rating scale, with 1 = highly dissatisfied to 100 = highly satisfied [1] at the following time points; 6h, 12h, 24h, 36h and 48h after surgery.
Results: Both groups were matched as regard age, sex, bypass and ischemic times as well as to the type of surgery and duration of mechanical ventilation and hospital stay. No significant differences were observed between groups as regard the analgesic efficacy, sedation scale and satisfaction with the type of analgesia. However, 11 patients in tramadol group experienced nausea and vomiting versus 7 patients in fentanyl group (p=0.215 by Fisher’s exact test). Also, 13 patients requested boluses of tramadol as rescue analgesia 25-50 mg in tramadol group, while 8-patients required 25-50 μg fentanyl in fentanyl group, p=0.121 by Fisher’s exact test.
Conclusion: It appears from this study that tramadol infusion offers a comparable analgesic efficacy to fentanyl after cardiac surgery.