Postoperative analgesia with tramadol and indomethacin for diagnostic curettage and early termination of pregnancy

Int J Obstet Anesth. 2011 Jul;20(3):236-9. doi: 10.1016/j.ijoa.2011.03.002. Epub 2011 Jun 2.

Abstract

Background: The postoperative analgesic effects of rectal indomethacin and tramadol were compared in patients undergoing elective termination of first trimester pregnancy and diagnostic dilatation and curettage.

Methods: Eighty-one American Society of Anesthesiologists class I and II women undergoing first trimester termination of pregnancy or diagnostic dilation and curettage were randomly allocated to receive rectal suppositories of either tramadol 100 mg (n=41) or indomethacin 100 mg (n=40) 90 min before induction of anesthesia. Pain scores and side effects were evaluated until discharge. Intraoperative anesthetic and postoperative analgesic consumption was also recorded. Intravenous metamizole 1 g was employed for postoperative rescue analgesia.

Results: When compared to the indomethacin group, the tramadol group required less intraoperative propofol [136 mg ±28 vs. 160 mg ±35 (P=0.001)], less rescue analgesia [2.4% vs. 22% (P=0.005)] and lower visual analogue pain scores [2.4 ±8 vs. 23 ±22 (P=0.005)]. The incidence of postoperative nausea and vomiting was similar in both groups.

Conclusion: When compared to indomethacin 100 mg, preoperative administration of tramadol 100 mg provides superior postoperative analgesia with minimal adverse effects.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abortion, Induced*
  • Adult
  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Anesthesia, General
  • Anti-Inflammatory Agents, Non-Steroidal / administration & dosage
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use*
  • Dilatation and Curettage*
  • Female
  • Hemodynamics / drug effects
  • Humans
  • Indomethacin / administration & dosage
  • Indomethacin / adverse effects
  • Indomethacin / therapeutic use*
  • Pain Measurement
  • Pain, Postoperative / drug therapy*
  • Postoperative Nausea and Vomiting / epidemiology
  • Pregnancy
  • Pregnancy Trimester, First
  • Respiratory Mechanics / drug effects
  • Suppositories
  • Tramadol / administration & dosage
  • Tramadol / adverse effects
  • Tramadol / therapeutic use*

Substances

  • Analgesics, Opioid
  • Anti-Inflammatory Agents, Non-Steroidal
  • Suppositories
  • Tramadol
  • Indomethacin