[Intravenous postoperative pain management using nalbuphine and tramadol. A combination of continuous infusion and patient-controlled administration]

Abstract

The aim of the study was to examine the analgesic efficacy and applicability of the two analgesic drugs nalbuphine and tramadol, administered by continuous i.v. infusion combined with a patient-controlled analgesia device (PCA).

Methods: With informed consent and approval of the ethical committee, 40 patients were studied after abdominal hysterectomy in a randomized, double-blind order. Twenty received an initial postoperative dose of 10 mg nalbuphine followed by a continuous infusion of 5 mg/h and the possibility of an additional 5 mg every 30 min. The other 20 received equipotent analgesia consisting of an initial bolus of 50 mg tramadol i.v. followed by a continuous infusion of 25 mg/h and the possibility of an additional 25 mg every 30 min. Analgesia, sedation, general well-being, and acceptance of the patients as well as blood pressure, heart rate, respiratory rate, and pulse-oximetric O2 saturation were measured regularly during a 5-h postoperative period. Data were analyzed using the Mann-Whitney test, with P less than 0.05 considered significant; results were expressed as mean +/- standard deviation.

Results: The postoperative pain score on the visual analogue scale (0 to 10) fell with nalbuphine from 7.14 +/- 3.45 to 2.03 +/- 1.25 and with tramadol from 7.81 +/- 2.85 to 1.57 +/- 1.40. There were no significant differences between the two groups. PCA supplements were requested 21.7 times in the nalbuphine group and 27.3 times in the tramadol group. General well-being of the patients on a 4-point scale (0 to 3) improved for the nalbuphine group from 0.70 +/- 0.92 to 2.11 +/- 0.49 and for the tramadol group from 0.62 +/- 0.67 to 2.33 +/- 0.50, which was significantly better in the nalbuphine group after 45, 60, and 90 min.(ABSTRACT TRUNCATED AT 250 WORDS)