Abstract
OBJECTIVES: To compare the analgesic effect of pre-operatively administered combination of dexamethasone and tramadol versus tramadol only on post-operative pain scores of patients undergoing open appendectomy.
STUDY DESIGN: A Randomized, double-blinded, parallel group study.
PLACE AND DURATION: Study was carried out in Accident and Emergency Department of Benazir Bhutto Hospital, Rawalpindi from 1st February 2017 to 27th March 2017.
METHODOLOGY: 64 patients undergoing open appendectomy were enrolled using the inclusion criteria and interventional protocol was randomized across two parallel groups; 1st group received pre-operative intravenous combination of dexamethasone and tramadol and the 2nd group received tramadol only. The pharmacological variables of anaesthesia were kept at a constant level for all the participants of the study. Pain was assessed at 0-4 hours post-operatively using the Numeric Rating Scale (NRS).
RESULTS: There were 32 patients in 1st group (combined dexamethasone tramadol) and 30 patients in 2nd group (tramadol only). Mean post-operative pain score(as per NRS) at 0-4 hours was 3.06 in group 1 while it was 4.53 in group 2 (p value=0.002) Among the 1st group, a remarkable 65.6% had only mild pain(NRS 1-3) and 34.3% had moderate pain(NRS 4-6). Among the 2nd group, 30% had mild pain, 53.3% had moderate pain, while 16.6% of the patients had severe post-operative pain (NRS 7-10). Regarding rescue analgesia, only 34.3% of combined dexamethasone tramadol group had to be administered additional post-operative analgesia.
CONCLUSION: Pre-operative administration of a combination of intravenous dexamethasone and tramadol results in statistically significant lesser pain scores and decreased requirement of rescue analgesia at 0-4 hours post-operatively in patients undergoing open appendectomy for acute appendicitis.
Muhammad Nauman Zafar, Ubair Ullah Shaheen , Rafay Ali Khan , Ammar Zaman Khan . (2018) The Analgesic Effect of Pre-Operatively Administered Combination of Dexamethasone and Tramadol on Post-Operative Pain in Patients Undergoing Open Appendectomy- Randomized Clinical Trial, Isra Medical Journal, Volume 10, 01.
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