A comparative study on the analgesic effect of tramadol, tramadol plus magnesium, and tramadol plus ketamine for postoperative pain management after major abdominal surgery
Article first published online: 21 AUG 2002
Acta Anaesthesiologica Scandinavica
Volume 46, Issue 8, pages 1025–1030, September 2002
How to Cite
ÜNlügenç, H., Gündüz, M., ÖZalevli, M. and Akman, H. (2002), A comparative study on the analgesic effect of tramadol, tramadol plus magnesium, and tramadol plus ketamine for postoperative pain management after major abdominal surgery. Acta Anaesthesiologica Scandinavica, 46: 1025–1030. doi: 10.1034/j.1399-6576.2002.460817.x
- Issue published online: 21 AUG 2002
- Article first published online: 21 AUG 2002
- Received 10 September 2001, accepted for publication 9 February 2002
- NMDA receptor antagonists;
- patient-controlled analgesia;
- postoperative analgesia;
Background: We tested whether, after major abdominal surgery, the addition of magnesium or ketamine to tramadol for intravenous (IV) patient-controlled analgesia (PCA) improved analgesia and lowered pain scores, compared to a PCA containing only tramadol.
Methods: Sixty-six patients were allocated randomly to receive a PCA with tramadol alone (T), tramadol plus magnesium (TM) or tramadol plus ketamin (TK), in a double-blind randomized study. Postoperative analgesia was started when the verbal rating scale (VRS) score was 2 or more. Following a loading dose of the study solution (which contained 1 mg/kg tramadol), a background infusion of 0.4 mg/kg/h was started. Patients were allowed to use bolus doses of 0.2 mg/kg every 20 min without a time limit. Discomfort, sedation, pain scores, total and bolus PCA tramadol consumption, and side-effects, were recorded for up to 24 h after the start of PCA.
Results: Pain and discomfort scores were lower (P < 0.01) in groups TM and TK at 15, 30, 60 and 120 min than in group T. The addition of magnesium or ketamine significantly reduced the consumption of tramadol at 6, 12 and 24 h (P < 0.01). The incidence of nausea did not differ between the groups.
Conclusion: Adding magnesium or ketamine to tramadol improved analgesia and patient comfort and decreased the amount of tramadol required for postoperative pain management after major abdominal surgery.