The Effect of Preoperative Administration of Tramadol on Post-laparoscopic Pain Relief in Women Compared to Placebo

Tramadol is an analgesic with combined opioid agonist and monoamine reuptake blocker properties which may be useful as a preoperative analgesic and antinociceptive adjuvant. The aim of this study was the evaluation of preoperative tramadol administration on pain intensity, postoperative analgesic consumption and side effects compared to placebo. In this randomized, double-blind, placebo-controlled clinical trial 70 infertile, ASA class I or II patients were scheduled for diagnostic gynecologic laparoscopy. Fifty mg tramadol was injected into 35 patients before the operation and the other 35 patients received normal saline. The patients who received preoperative tramadol, had a lower pain score within six hours after the operation (1.31±0.94 compared to 2.93±0.55 p< 0.0001). Ten patients (28.57%) in tramadol group and 33 patients in placebo group had post-operative pain (p< 0.0001). The mean consumption of post-operative tramadol was statistically lower in treatment group (9.46 ±25.92) than in placebo group (45.95 ± 37.96) (p<0.0001). Post- operative sedation level 15 minutes (p=0.71) and 30 minutes (p=0.88) after the operation had no significant difference between the two groups. The frequency of post-operative nausea in treatment group (5.71 %) was significantly lower than placebo group (25.71 %) (p=0.04). Administration of a single dose of tramadol one hour before operation provides effective pre-emptive analgesia in patients undergoing diagnostic gynecologic laparoscopies without affecting sedation level.