The effects on analgesia and respiratory parameters of intravenous tramadol and dexmedetomidine added to tramadol using postoperatively in the thoracic surgery

In our study, we aimed to compare postoperatively using tramadol with tramadol+dexmedetomidine by the aspects of effects on pain control, sedation and pulmoner functions.30 patients in status ASA I-III, 15-65 years of age, undergoing elective thoracic surgery were included in the study. At the end of the operation, all patients were connected to the PCA (Patient Controlled Analgesia) device and were dosed with a 50 mg loading dose of 400 mg tramadol adding to 100 cc %0.9 SF and patients were randomly divided into two groups. Group 1 (The tramadol group: Given tramadol 0.07 ml/h with infusion, 10 mg bolus dose and 20 minutes lock-out interval following 50 mg loading dose for 24 hours. Group 2 (The dexmedetomidine+tramadol group): As the same in Group 1, else we administered dexmedetomidine 0.4 µg/kg/h with infusion for 24 hours following 1 µg/kg/20min loading dose.When the VAS score decreased under 5, the infusion dose of tramadol was reduced to the half amount. In the postoperative period, hemodynamic data, blood gases, pain scores, sedation scores, respiratory function tests and side effects were recorded.In the statistical analysis, meaningful decrease was found at the pain scores of Group 2 in the 4th and 8th hours and, meaningful increase was recorded at the sedation scores of Group 2 in the 1st, 2nd, 4th and 8th hours (p<0.05). Also meaningful reduction was recorded at tramadol consumption of Group 2 (p<0.05). And the adverse effect of dry mouth was found in a high rate in Group 2. In two groups (p<0.05), respiratory function test values were found lower than preoperatively baseline values (p<0.05), but increased incrementaly by hours.In our study we concluded that the addition of dexmedetomidine to tramadol makes a successful pain control, decreases the consumption of tramadol with a valuable amount and makes respiratory function tests better by hours. Therefore we think that dexmedetomidine is an effective adjuvant. And also we expect that the patients will be more comfortable in Intensive Care Unit.