The effect of intravenous paracetamol on tramadol consumption in children undergoing major abdominal surgery

Purpose: Postoperative pain and related hemodynamic instability are frequently observed problems in major abdominal surgery. Patient Controlled Analgesia is frequently used method in postoperative pain management. In this study, we aimed to determine the effect of postoperative tramadol consumption and analgesic efficacy in applying perioperative intravenous only single dose of paracetamol.Material and Methods: After approval of Faculty Ethical Committee and parents consent, 91 children aged 3 - 14 years undergoing major abdominal surgery were included in the study. Patients randomly divided into two groups. Group I patients received perioperative paracetamol (15 mg / kg) in 15 minutes via intravenous infusion before 45 minutes from the end of the operation. Group II patients received tramadol (1 mg /kg) via intravenous bolus before 30 minutes from end of the operation. Tramadol (0,2 mg / kg PCA, 20 minutes locked in time) infusion was started with patient controlled analgesia (PCA) in both groups. Systolic and diastolic blood pressures, heart rates, oxygen saturation values, pain scores (Children?s Hospital of Eastern Ontorio Pain Scale = CHEOPS), total tramadol consumption and side effects were recorded, postoperatively.Results: Demographic data, operation times and hemodynamic parameters of groups were similar in groups. Total tramadol consumption was recorded in 24 hours for group I was 76,11 ± 105,65 mg, and group II was 83,50 ± 97,35 mg. There were not any significantly difference in side effects, postoperative tramadol consumption and pain scores between the groups. (p > 0,05)Conclusions: In our study, it is concluded that intravenous paracetamol in combination with tramadol administered by PCA provides effective and similar analgesia compared to intravenous tramadol application but it was not superior to tramadol in children undergoing major abdominal surgery.