Tramadol for Pain Relief in Children Undergoing Adenotonsillectomy: A Comparison with Dextromethorphan


  • Editor's Note: This Manuscript was accepted for publication April 1, 2008.


Objective/Hypothesis: Establishment of good analgesia is of major concern in the postoperative period after adenotonsillectomy. The aim of this study was to compare the effects of dextromethorphan and tramadol on postoperative pain after adenotonsillectomy in children.

Study Design: Randomized study.

Methods: Ninety ASA class I, II (children age, 4–10 years) scheduled for adenotonsillectomy were randomized into three groups to receive placebo syrup (control group), 1 mg/kg dose of dextromethorphan cough syrup oral (Dex group) or oral placebo syrup (Tramadol group), 30 minutes before arrival in the operating room. Then during induction of anesthesia group control received 0.9% physiological saline, group Dex received 0.9% physiological saline, group Tramadol (1 mg/kg) of tramadol hyrochloride intravenously, in a total volume of 4 mL. Postoperative analgesic requirements and side effects were recorded. Pain was assessed by face scale every hour up to 6 hours postop.

Results: There were no statistically significant differences in age, weight, and sex between groups (P > .05). There were statistically significant differences in, pain scores in first time postoperatively and further analgesic requirements (P < .05). All patients in placebo group (100%), two patients in the tramadol group (6.6%), and nine patients in dextromethorphan group (40%) required supplementary meperidine in recovery room. The incidence of nausea and vomiting was 5.5% in the Dextrometorphan group, 10% in the tramadol group, 6.6% in the control group; there was no significant difference between the groups (P > .05).

Conclusions: Intravenous tramadol (1 mg/kg) is more suitable than 1 mg/kg dose of dextromethorphancough syrup oral in reducing posttonsillectomy pain in children.