مقايسه تأثير سه داروي ترامادول، ايندومتاسين و استامينوفن در كنترل درد بعد از عمل جراحي باي پاس عروق كرونر

Comparison of the analgesic effect of tramadol, indomethacin and acetamino-phen after coronary artery bypass graft surgery

Background: Pain control is an important aspect in postoperative care of patient undergoing surgical intervention. Systemic opioids are the cornerstone options for the control of postoperative pain. In this study we evaluated analgesic effect of tramadol, indomethacin and acetaminophen for reducing opioid usages and their side effect. Materials and Methods: This randomized clinical trial study was performed on 92 patients scheduled for CABG surgery. Patients were randomly divided into three groups: (A: Acetaminophen, B: Tramadol and C: Indomethacin). Patients were evaluated for pain scoring daily by numerical rating scale (NRS) in three location that including median sternotomy, chest tube insertion and back pain at costovertebral junction. Drug side effects (Nausea and bleeding) and additional required morphine were recorded. Results: Three groups were similar in age, sex, diabetes, LIMA harvesting and induction and maintenance of anesthesia. Back pain at costovertebral junction was the most painful area with maximum severity in group A (p-value ~ 0.013 first day, p-value ~ 0.001 second day and p-value ~ 0 third day). The addition of morphine for pain relief in first and second postoperative day was the most in group A and the least in group B (p-value ~ 0.004 and p-value ~ 0.003 respectively). There was no significant difference in pain intensity of median sternotomy and chest tube insertion chest pain between three groups (p-value > 0.05). There was no significant difference in vomiting and chest tube drainage between three groups (p-value >0.05). Conclusion: Based on results of this study the tramadol produced better postoperative pain relief with a decrease in morphine consumption to reduce adverse effects.