Post-herniorrhaphy infiltration of tramadol versus bupivacaine for postoperative pain relief: a randomized study

BACKGROUND AND OBJECTIVES: Inguin al hernia repair is frequentl y associated wi th persistent postoperativediscomfort and pain and late discharge from the hospital. We evaluated the postoperative analgesic effect oflocal wound infiltration with tramadol following herniorrhaphy among adult patients.PATIENTS AND METHODS: Forty-thr ee adult male patients were randomly ass igned to two groups; group T(n=23) received tramadol 1 mglkg in 10 mL 0.9% normal saline and group B (n=20) received 10 mL of 0.25%bupivacaine, both as a local wound infiltration prior to skin closure. Postoperativ ely, pain severity, tim e to firstanalgesic requirement, analgesic consumption, and incid ence of side effects were record ed.RESULTS: During the fir st postoperative day, there was a signifi cant difference between the two group s in the recordedvisual analog scale rating higher in group B (P .05) and the tim e to first analgesic requirement (6.6±0.99hours in group B vs 3.7±0.74 hours in group T; P .05 ). There was no difference in the incid ence of side effectsamong the two groups. Postoperative consumption of fentanyl and diclofenac was higher in group B than groupT (65% vs 18% and 80% vs 21.7%, respectively, P::;.005).CONCLUSIONS: Locally infiltrated tramadol prior to herniorrhaphy wound closure provides better pain reliefcompared to bupivacaine in adult patients.