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East and Central African Journal of Surgery
Association of Surgeons of East Africa and College of Surgeons of East Central and Southern Africa
ISSN: 1024-297X EISSN: 1024-297X
Vol. 22, No. 1, 2017, pp. 80-87
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Bioline Code: js17011
Full paper language: English
Document type: Research Article
Document available free of charge
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East and Central African Journal of Surgery, Vol. 22, No. 1, 2017, pp. 80-87
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Post Operative Pain Control in Inguinal Hernia Repair: Comparison of Tramadol Versus Bupivacaine in Local Wound Infiltration: A Randomized Controlled Trial
Niyirera, E; Kiswezi, A & Ntirenganya, F
Abstract
Background: Post-operative pain control is a key factor in surgery. It greatly increases
patient satisfaction, and influences the hospital stay period.
Local wound infiltration has often been used to control postoperative pain following
hernia surgery, with the use of the conventional local anesthetics like Lidocaine or
Bupivacaine. The use of Tramadol for local wound infiltration is new and not yet practised
in Rwanda. The aim of this study was to compare the postoperative pain control effects
and cost effectiveness of Tramadol versus Bupivaaine in wound infiltration following
inguinal hernia repair.
Methods: This was a randomized controlled trial conducted between September 2015 and
February 2016. Randomization was done using a sealed envelope containing the name of
drug to be used for local wound infiltrations following inguinal hernia repair.
Results: A total of 52 patients were enrolled equally in the two study groups. Only one
female patient enrolled in the study. Tramadol was found to be superior to Bupivacaine in
providing postoperative pain control. (P=0.000). Pain free period was 4.7±1.3 hours in
Bupivacaine group while it twas more than 12 hours in Tramadol group. Additional
analgesia request in both groups was significantly different, in favor of Tramadol.
(P=0.000). No complications reported in both groups. Bupivacaine was found to be 5 times
more expensive than Tramadol.
Conclusion: Wound infiltration with Tramadol after open inguinal hernia repair offers a
superior and prolonged pain control compared to Bupivacaine. The need of additional
analgesics is very low after Tramadol wound infiltration compared to Bupivacaine used in
the same conditions. In addition, Tramadol is cheaper making its use cost affordable
Keywords
Postoperative pain, Wound infiltration, Tramadol, Bupivacaine/ macaine.
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© Copyright 2017 - East and Central African Journal of Surgery
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