Intravenous patient-controlled analgesia after thoracotomy: a comparison of morphine with tramadol
Background and objective: This study examined the quality of analgesia together with the side-effects produced by tramadol compared with morphine using intravenous patient-controlled analgesia during the first 24 h after thoracotomy.
Methods: Forty-four patients scheduled for thoracotomy were included in the study. Morphine 0.3 mg kg−1 was given interpleurally 20 min before a standard general anaesthetic. In the postanaesthetic care unit, the patients were randomly allocated to one of two groups to self-administer tramadol or morphine using a patient-controlled analgesia device throughout a 24 h period. The patient-controlled analgesia device was programmed to deliver tramadol 20 mg as an intravenous bolus or morphine 2 mg with a lockout time of 10 min.
Results: Mean cumulative morphine and tramadol consumption were 48.13 ± 30.23 and 493.5 ± 191.5 mg, respectively. There was no difference in the quality of analgesia between groups. Five (26.3%) patients in the tramadol group and seven (33%) in the morphine group had nausea, and three of the latter patients vomited. The incidence rate of vomiting with tramadol was 5.2%. All vital signs were within safe ranges. Sedation was less in the tramadol group, but not statistically significant.
Conclusions: In this clinical setting, which includes interpleural morphine pre-emptively, postoperative analgesia provided by tramadol was similar to that of morphine at rest and during deep inspiration. Side-effects were slight and comparable between the patients receiving morphine and tramadol.(Accepted March 2002)
Key Words: ANALGESIA, patient-controlled; ANALGESICS, OPIOID, morphine, tramadol; PAIN, postoperative; POSTOPERATIVE COMPLICATIONS, postoperative nausea and vomiting; THORACIC SURGICAL PROCEDURES, thoracotomy.
c1 Correspondence to: Lale Yüceyar, Turunçlu sok. Ugur apt. 23/A D: 25, Merter 34010, Istanbul, Turkey. E-mail: Lyuceyar@hotmail.com; Tel: +90 212 502 35 35; Fax: +90 212 529 56 00