Analgesic Efficacy of Oral Tramadol in Post Operative Caesarian Section Patients

Abstract

Objective: To compare the analgesic efficacy of oral tramadol in post-operative lower segment caesarian section patients with intravenous analgesics.
Methodology: The randomized controlled trial was conducted in department of Obstetrics and Gynecology at Kahuta Research Laboratories (KRL) hospital, Islamabad over the period of four months from Nov, 2017 to Feb 2018. Patients were randomly assigned in two groups on day of operation. One group was given oral tramadol and the other one routine intravenous nalbuphine analgesia. Pain scores were compared using visual analogue scale at 4, 8 and 12 hours postoperatively. Patients with higher scores were reverted to intravenous analgesia. Mean pain scores of both groups were calculated using SPSS 23 and independent student t test applied for comparison of means.
Results:A total of 320 patients were randomly divided into two equal groups. The analgesic efficacy of oral tramadol was comparable to intravenous nalbuphine as assessed by the visual analogue score at 4hours (p=0.278) and 12 hours (p=0.470) post operatively. But the pain score at 8hours was significantly lower in intravenous group (p=0.016). A total of 17 patients in oral group were reverted to intravenous analgesia group (p=0.008). Side effects like sedation, drowsiness and nausea/vomiting were also not significant in both groups(p=0.852).
Conclusion: Oral tramadol is a safe post operative analgesic which is as effective in reducing pain as intravenous analgesia and can be used as an alternative.