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Review paper

The preemptive effect of tramadol and metamizole on the intensity of postoperative pain

By
Ismet Suljević Orcid logo ,
Ismet Suljević
Contact Ismet Suljević

Clinic for Anaesthesia and Resuscitation, Clinical Centre of University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Muamer Hadžiavdić ,
Muamer Hadžiavdić

Clinic for Bone Surgery, Clinical Centre of University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Ismana Šurković ,
Ismana Šurković

Department for Endocrinology, Diabetes, and Diseases of Metabolism, Clinical Centre of University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Omer Suljević ,
Omer Suljević

Sarajevo Health Centre, Sarajevo, Bosnia and Herzegovina

Maida Turan ,
Maida Turan

Healthcare Group Acibadem, Representative Office in Sarajevo, Sarajevo, Bosnia and Herzegovina

Ehlimana Mušija
Ehlimana Mušija

Clinic for Heart Diseases and Rheumatism, Clinical Centre of University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Abstract

Aim
To demonstrate the analgesic effect of preemptively administered tramadol and metamizole on the postoperative pain severity, after an elective operative hysterectomy with adnexectomy.
Methods
There were three groups with 30 patients in each group. Patients included in the study were between 45 to 67 years old. They were all in the ASA group II. Randomization was performed in random order according to the regular elective operating program. Patients in Group I received i. m. tramadol 1mg/kg, and in Group II 30mg/kg of metamizole, five minutes before anaesthesia induction. Patients did not receive preemptive analgesia in Group III (control). All patients underwent the same induction anaesthesiology procedure with propofol, fentanyl, tracrium, supplemented with O2, N2O, and sevoflurane at an appropriate dose until MAC 1 was reached. Surgeries lasted for 80-120 minutes. Every patient performed a resting pain assessment 30 minutes after an extubation by Numerical Pain Scale (NPS).
Results
We found out that tramadol had a better effect in preemptive analgesia and that the average pain score for Group I was 6.10 (p=0.043). In Group II, it was 7.93 (p=0.022). There is significant difference in pain intensity between patients in the control group, (pain intensity was 9.16), and those who received tramadol and metamizole. There was no significant difference in the intensity of pain when using these two analgesics (p=0.733).
Conclusion
The effect of preemptively administered tramadol prior to the introduction of general anaesthesia in postoperative pain is significantly more favourable than the effect of metamizole.

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