Study of intravenous tramadol versus rectal tramadol for postoperative analgesia after appendectomy

Introduction: Tramadol is atypical opioid having central as well as peripheral analgesic action. It acts on opioid receptors as well as having effect on neuronal reuptake of nor epinephrine and serotonin. In this study, the effects of tramadol given by two different routes, intravenous and rectal, were compared in terms of analgesic efficacy and duration as well as its side effects in appendectomy patients. Material and Methods: Forty patients of acute appendicitis undergone appendectomy under spinal anesthesia between age group of 20 to 50 years, of either sex having weight of 40 to 70 kg and ASA 1 or 2 physical status were included in the study to receive either Tramadol 100mg intravenously (Group A) or 100 mg rectal suppository (Group B) at the end of surgery. First onset of pain, VAS score, rescue analgesic requirement and side effects noted. Results: Demographic parameters were comparable in both groups. Mean duration of first onset of pain in group B (417.5±128.22min) was longer than group A (304±86.16 min) and it was statistically significant (tailed significance value of 0.0010). Rescue analgesic requirement was significantly prolonged in group B than group A. Also incidence of postoperative vomiting was less in group B than group A (5% Vs 20%). Conclusion: We conclude that rectal tramadol can be better alternative to intravenous tramadol for postoperative analgesia in appendectomy.