RESUMO
In this study, the local anesthetic and post-operative analgesic effects of tramadol were compared to those of lidocaine in minor surgeries under local anesthesia. This double-blind clinical trial study included 70 patients in ASA physical status I and II, aging between 20 and 50 years, undergoing minor surgery [lipoma excision and revision of scars less than 4 cm within 30 minutes or less] under local anesthesia. The patients were randomly assigned to receive either 2 mg/kg tramadol [group T, n=35] or 1 mg/kg lidocaine 2% [group L, n=35] subcutaneously. Scores of the pain sensation were recorded as VAS [visual analogue scale 0-10] during injection, incision and 15, 30 and 45 minutes after incision, and then 2, 4 and 6 hours post-operatively at the ward. There was no significant difference between pain scores of the two groups during injection, incision and surgery or in the post-operative period at the ward [p=0. 181]. Incidence of nausea was 0% and 22. 8% in group L and group T, respectively. The difference was statistically significant [p=0.002]. Furthermore, 82. 9% of subjects in group L and 60% of subjects in group T needed acetaminophen to control their pain and the difference was significant [p=0.004]. Tramadol 2 mg/kg has local anesthetic and post-operative analgesic effect equal to lidocaine 1 mg/kg in minor surgeries performed subcutaneously. Therefore, we concluded that tramadol can be used as an alternative drug to lidocaine in local anesthesia and has the ability to decrease the demand for post operative analgesics
RESUMO
Recent studies have shown that Tramadol has local anesthetic effects in addition to its classical analgesic effect. In this study, the local anesthetic and postoperative analgesic effects of Tramadol were compared with those of Lidocaine in minor surgeries under local anesthesia. If the efficacy of Tramadol in this regard is proven, it will make considerable advances in the local anesthetic area. In this random double-blinded clinical trial study, seventy patients aged between 20 to 50 in ASA physical status of I and II underwent subcutaneous block for minor surgeries. The patients were randomly assigned to receive either 2 mg/kg of Tramadol [group T, n=35], or 1 mg/kg of Lidocaine 2% [group T, n35] subcutaneously. The mean degrees of pain sensation were recorded on the VAS [visual analogue scale 0-10] during injection, incision, and every 15 minutes at the 15th, 30th, and 45th minutes after the incision, and then every two hours at the 2nd, 4th, and 6th hours postoperatively in the ward. The data were analyzed using repeated measures and Chi-square. When the VAS of pain during surgery exceeded 4, an additional 0.5 mg/kg of the study drug was injected. The patients with the VAS of 4 or more were advised to take Acetaminophen 325 mg if necessary. There were no significant differences between the pain score of the two groups during injection, incision, surgery, and postoperative time [p=0.181]. Additionally, no significant differences were found in local skin reaction [p=0.104], bleeding quantity [p=0.112], additional dose of local anesthetic [p=0.48], and incidence of vomiting [p=0.114]. The incidence of nausea [0%] in group L and [22.8%] in group T, showed a statistically significant difference [p=0.002]. In group L, need for Acetaminophen to control their pain was higher than in group T. Tramadol 2 mg/kg has equal local anesthetic and postoperative analgesic effects like Lidocaine 1 mg/kg for minor surgeries performed subcutaneously. Therefore, it is recommended that Tramadol can be used as an alternative drug to Lidocaine in local anesthesia because it is able to decrease the demand for postoperative analgesics