Introduction and Objectives
Recently, it has been shown that tramadol was an effective local anaesthetic in minor surgery. The aim of this study was to compare the local anaesthetic effects of tramadol hydrochloride with prilocaine for circumcision procedure.
Material and Methods
This article was planned with 40 ASA-I patients undergoing circumcision for religious belief. Patients were randomly allocated to receive either 5% tramadol (2 mg/kg) plus adrenaline (0.0125/cc) (Group 1, n = 20) or 2% prilocaine plus adrenaline (0.0125/cc) (Group 2, n = 20). Both were infiltrated intradermally in a circumferential pattern and in a double-blinded fashion. The degree of the burning sensation and pain at the injection site were documented. Sensory block was assessed 1 min after injection and they were asked to grade touch and pinprick sensation. Five minutes after drug administration, incision was performed and intensity of pain, felt by the patient was evaluated on a four-point scale (0–3). Injection site pain and local skin reactions were also recorded.
Results
Mean ages were 9.7 and 10.3 years for Groups 1 and 2, respectively. Mean duration of surgery was 19.6 minutes. Throughout the operation and in early postoperative period, no local or systemic adverse effect was observed. All children were discharged on same day. After 24 hrs, patients were invited for control. In control visit, 2 out of 20 (10%) in Group 1, and 10 out of 20 (50%) children in Group 2, reported extra need for oral Ibuprofen (p < 0.05). First analgesic medication time was 9.5 (±2.1) hours (hrs) in group 1, and 8.7 (±3.1) hrs in Group 2 (p > 0.05). Total postoperative Ibuprofen consumptions were 10 and 50 miligrams for Group 1 and 2, respectively (p < 0.05).
Conclusions
A combination of tramadol 5% plus adrenaline can provide a safe and effective local anaesthesia during circumcision procedure and postoperative period in children.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.