Comparative study of the analgesic efficacy of rectal tramadol versus intravenous tramadol for adult tonsillectomy

BACKGROUND: The optimal method for intra- and post-operative analgesia for adult tonsillectomy is uncertain. Tramadol hydrochloride is an analgesic with mixed mu and nonopioid activities, having less/no respiratory depression. AIM: The aim of our study was to compare the analgesic efficacy and nausea/vomiting produced by tramadol via intravenous and rectal administration during the first 24 h after anesthesia for adult tonsillectomy. MATERIALS AND METHODS: The study design was prospective, randomized, single blind and hospital based. Forty adult patients of ASA grade 1 and 2 posted for tonsillectomy were randomized to receive either intravenous tramadol (1 mg/kg) (n=20) Group A or rectal tramadol (1.5-2 mg/kg), maximum 100 mg (n=20), Group B immediately after the induction of anesthesia. Pain measurement was performed using visual analogue scale. Rescue analgesia was given when the VAS was ≥3 in the postoperative period up to 24 h. Complaint of nausea/vomiting was recorded during the same period. RESULTS: Duration of analgesia was prolonged and requirement of rescue analgesics was less with the suppository group. Nausea and vomiting were lower with the suppository group. CONCLUSION: The rectal route of tramadol is a better alternative to the intravenous route in comparison with the duration of analgesia and nausea/vomiting for adult tonsillectomy.