RANDOMIZED COMPARISON OF EFFICACY, DURATION OF ACTION, ADVERSE REACTIONS AND COST EFFECTIVENESS OF PENTAZOCINE AND TRAMADOL ON RELIEF OF POST OPERATIVE PAIN

Description

Background: Many options are available for the treatment of postoperative pain. By considering patients’ preferences and making an individualized assessment of the risks and benefits of each treatment modality, the clinician can optimize the postoperative analgesic regimen for each patient. Material method: Female patients of age between 30 to 60 years undergoing elective abdominal and vaginal hysterectomies were included in this study. Hysterectomies performed under spinal anesthesia. Group I constituted patients who received Tramadol 50 mg intravenously; Group II constituted patients who received Pentazocine 30 mg intravenously for post-operative analgesia. The study drugs were administered postoperatively to the patients after the effect of spinal anesthesia wears off and the patient complained of pain. Before administering the study drug an assessment Visual analogue score of was done, and after giving the study drug, the pain was assessed subjectively at 0 minutes and at every 30 minutes for 6 hrs. Each patient’s pain was recorded on a scale 0-10 by their response to a visual analogue pain scale. The onset of analgesic action, time at which maximum pain relief occurs, duration of minimal pain, a total duration of analgesic action and any acute side effects were noted, the average cost-effective ratio was studied. Results: The range of onset of analgesia in both the groups was 10 to 20 minutes when comparing the mean value of onset of analgesia of the two groups, the mean value of the tramadol group was 14.92 ± 3.89 minutes and that of pentazocine was 14.66 ± 3.23 minutes. The range of duration of analgesia in the two groups was the same, which was 5 to 6 hours. The mean duration of postoperative analgesia in the tramadol group was 5.77 ± 0.33 hours, whereas in the pentazocine group it was 5.67 ± 0.39 hours. In the tramadol group 45 patients (90%) had only mild pain and 5 patients (10%) had moderate pain. Whereas in pentazocine group 40 (80%) patients had mild pain and 10 patients (20%) had moderate pain. The duration of minimal pain in both groups was 1.5 hours (from 2 to 3.5 hours). The common side effects were nausea, vomiting, headache, drowsiness, respiratory depression. Conclusion: We conclude that intravenous tramadol 50 mg and intravenous pentazocine 30 mg produced adequate postoperative analgesia and intravenous tramadol 50 mg was safe and more cost effective.