The effects of different tramadol doze regimens on patient confort in patient controlled analgesia in orthopedic lower extremity surgery

We applied tramadol HCl with PCA at different doses to ASA I-II patients in postoperative period in elective orthopedic lower extremity surgery and aimed to find the best dose regimen for patient comfort.We divided the patients to 4 groups randomly and Group I patients received 1 mg/kg tramadol HCl 2x1 (intravenous) in necessity, Group II patients received 0.5 mg/kg tramadol loading dose, 10 mg bolus dose, basal infusion in the rate of 8 mg/h, Group III patients received 1 mg/kg tramadol loading dose, 10 mg bolus dose, basal infusion in the rate of 8 mg/h and Group IV patients received 1.5 mg/kg tramadol loading dose, 10 mg bolus dose, basal infusion in the rate of 8 mg/h (intravenous). We applied 1 mg/kg tramadol HCl all the groups following the extubation. Patients received profilactic 3 mg granisetron HCl intravenously as antiemetic before the analgesia onset and at 12. hours postoperatively. We determined locked time of the PCA device in Group II, III and IV as 15 minutes and the maximum dose as 100 mg for four hours.We compared the groups for hemodynamic and respiratory parameters, postoperative pain score, sedation score and nausea-vomitting at 1., 6., 12. and 24. hours in the recovery room.In conclusion, we thought that the dose regimen applied in Group IV provided patient comfort most effectively for postoperative pain control in PCA procedure with tramadol HCl.Key words: Postoperative pain, patient controlled analgesia, tramadol HCl, postoperative pain score, granisetron HCl.