A comparative study of tramadol and pethidine in laparoscopic interval sterilization

Abstract

The new synthetic analgesic Tramadol was compared with pethidine in a double-blind prospective design for interval laparoscopic sterilization of 50 women in each group at Ramathibodi Hospital, Mahidol University, Bangkok. Drugs were administered iv by slow injection, after 15 mg midazolam had been given orally, 15 minutes before surgery. Both dose levels were 1 mg/kg. The laparoscopic technique was single-entry monopolar cautery without transecting the tubes. Analgesic effects were rated as slight (pain felt when fallopian tube was grasped, more medication needed); moderate (pain felt during cautery, verbalization); or good (slight or no pain during cautery). Analgesia was slight in 10% of both groups, moderate in 36% and good in 54% of the Tramadol group, and moderate in 24% and good in 66% of the pethidine group. Side effects were nausea and vomiting in 10-14% of women with both analgesics, and drowsiness and hypotension in 6 and 2% of the pethidine group (n.s.). Tramadol has the advantage of being non-addictive, and not contraindicated for asthmatics, nor is it listed as dangerous and restricted in Thailand.