Yonsei Med J.  2014 Sep;55(5):1436-1441. 10.3349/ymj.2014.55.5.1436.

Pre-Emptive Tramadol Could Reduce Pain after Ureteroscopic Lithotripsy

• Mimic A
• Dencic N
• Jovicic J
• Mirkovic J
• Durutovic
• Milenkovic-Petronic D
• Ladevic N

• KMID: 1799514
• DOI: http://doi.org/10.3349/ymj.2014.55.5.1436

Abstract

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 underwent ureteroscopic lithotripsy under general anesthesia in the Urology Clinic at the Clinical Center of Serbia from March to June 2012. All patients were randomly allocated to 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 analogue scale (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 effects of tramadol were assessed measuring pain scores, VAS1 and VAS2, intraoperative fentanyl 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 between the groups.
CONCLUSION
Pre-emptive tramadol did reduce early postoperative pain. The patients who received pre-emptive tramadol were less likely to experience severe post-operative pain.

Keyword

Pre-emptive; tramadol; post-operative pain; ureteroscopic lithotripsy

MeSH Terms

Adult
Analgesics, Opioid/*administration & dosage/therapeutic use
Female
Humans
*Lithotripsy
Male
Middle Aged
Pain/*prevention & control
Pain Measurement
Tramadol/*administration & dosage/therapeutic use
*Ureteroscopy
Analgesics, Opioid
Tramadol

Figure

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  Fig. 1 Average VAS1 and VAS2 score in tramadol and non-tramadol group. VAS, visual analogue scale.

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  Fig. 2 Distribution of VAS2 score between groups. VAS, visual analogue scale.

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