Tramadol

The aim of this study was to compare the analgesic efficacy of diclofenac sodium, ketorolac, tramadol individually and their combination after laparoscopic cholecystectomy. Total 150 subjects who met the inclusion and exclusion criteria were randomly (lottery method) divided into five groups to receive respective treatment. Pain score was measured after 1, 2, 4, 6, 12, 24 and 48 hours after surgery through visual analogue scale. The data was statistically analyzed through SPSS (version 20.0). It is concluded on the basis of collected results that a combination of Non-Steroidal Anti-inflammatory Drugs and Opioid derivatives is much superior to achieve effective pain control than either of the drug alone. Furthermore, ketorolac and tramadol combination provided more efficient pain control than diclofenac sodium and tramadol combination. This effective pain control is associated with short hospital stay which will cause less economic burden for patients. So, we may recommend that Non-Steroidal Anti-inflammatory Drugs (ketorolac) and opioids (tramadol) combination should be used for effectual pain control after laparoscopic cholecystectomy.

Pain is defined by the International Association for the Study of Pain as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Pain has now been equated to a fifth vital sign highlighting the significance of pain management in patient care. Tramadol is a centrally acting analgesic which is structurally related to codeine and morphine. It is effectively used to treat moderate to severe acute and chronic pain in diverse conditions. Tramadol is placed on the second step of WHO analgesic ladder and in contrast to traditional opioids, exerts its analgesic activity, a dual mechanism of action inhibiting transmission as well as perception of pain. Tramadol is more suitable than NSAID’s and coxib’s for patient with GI, renal and cardiovascular problems. Combined with low dependence/abuse potential, it has proven to be of significant advantage over other agents especially in the elderly.