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comparison of preemptive analgesic effect of intravenous nsaid (diclofenac sodium) versus tramadol used in pediatric inguinal herniotomy
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نویسنده
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ibrahim doaa mohamed almonayery ,abdelmonem ahmed elhadi ,ali wafaa ali abd elhadi ,morsy hayam shaaban soliman ,eid marwa ibrahim ,abdelaziz fatma mohamed ,salem eman a. ,eldesoky gehan abd elrhman ,gad asmaa ibraheim ,shams doaa elsaid ahmed ,hamouda samia ibrahim ibrahim ,gad dalia ,mohamed hanan mahmoud ,muhammad ahmad adel abdelhameed ,abdelrahman mohamed mahmoud abdelfattah ,abdalla usama ,doha mohamed ,omar mahmoud fahmy mohamed ,elsayed waleed a ,elkhouly ahmed ,shaheen salah kamal mohammad ,othman doaa samy abd alazez ,mahfouz mohamed ,almousa ahmad abdullah ,moussa mahmoud abd elhady ,omar abdulmabod ,el-ghobashy mohamed mokhtar ramadan
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منبع
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journal of medicinal and pharmaceutical chemistry research - 2026 - دوره : 8 - شماره : 2 - صفحه:457 -469
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چکیده
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The effective management of postoperative pain in pediatric patients remains a clinical challenge, particularly after day-case surgeries like inguinal herniotomy. the use of preemptive analgesia, which entails the administration of analgesics prior to surgical incision, is proposed to enhance pain outcomes. tramadol and diclofenac sodium are among the frequently utilized agents. however, there is a scarcity of comparative data concerning their efficacy and side effect profiles in children. the objective of this study is to evaluate the analgesic effectiveness and safety profile of intravenous tramadol compared to diclofenac sodium when administered preemptively to pediatric patients undergoing elective inguinal herniotomy.a randomized prospective study was conducted involving 50 children aged between 2 and 12 years who were undergoing day-case herniotomy with general anesthesia. the participants were randomly divided into two equal groups: group t, which received tramadol at a dosage of 0.5 mg/kg intravenously, and group d, which was administered diclofenac sodium at the same dosage of 0.5 mg/kg intravenously. pain levels were evaluated using the flacc scale at various time intervals in both the postanesthetic care unit (pacu) and the day-surgery unit (dsu). additionally, sedation levels, the necessity, and timing for rescue analgesia, as well as any side effects, were meticulously documented.flacc scores were significantly lower in the tramadol group during the pacu assessments at 30, 60, and 90 minutes, as well as in the dsu evaluations from 2 to 8 hours, when compared to the diclofenac group (p < 0.05). rescue analgesia was necessary for 92% of patients in the diclofenac group, in contrast to only 32% in the tramadol group (p = 0.007). the tramadol group also demonstrated advantages in both the dosage and the time to the first instance of rescue analgesia (p = 0.022 and p = 0.001, respectively). mild side effects, including nausea and vomiting, were observed, with no significant differences noted between the two groups.tramadol exhibited greater postoperative pain relief effectiveness than diclofenac sodium in children undergoing herniotomy, evidenced by lower pain scores and a diminished requirement for additional analgesics. both medications displayed similar safety profiles. these results endorse the application of intravenous tramadol as a viable preemptive analgesic in pediatric outpatient surgical procedures.
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کلیدواژه
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pediatric anesthesia ,tramadol ,diclofenac sodium ,preemptive analgesia ,inguinal herniotomy ,flacc pain scale ,postoperative pain ,postoperative analgesia
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آدرس
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girls al-azhar university, faculty of medicine, department of anesthesia, egypt, al-azhar university, damietta faculty of medicine, department of pediatric surgery, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, girls al-azhar university, faculty of medicine, department of anesthesia, egypt, al-azhar university, faculty of medicine for girls, department of pediatrics surgery, egypt, al-azhar university, faculty of medicine for girls, department of pediatrics surgery, egypt, hassan ghazzawi hospital, emergency and critical care department, alabeer medical group, saudi arabia, mansoura university, mansoura faculty of medicine, department of anesthesia and intensive care and pain management, egypt, mansoura university, mansoura faculty of medicine, department of anesthesia and intensive care and pain management, egypt, king abdulaziz university, king abdulaziz university hospital, department of anesthesia and critical care, saudi arabia, east jeddah hospital, department of pediatric surgery, saudi arabia, king fahd hospital of university, department of pediatric surgery, egypt, maternity and children hospital mch, department of pediatric surgery, saudi arabia, al-azhar university, faculty of medicine, department of anesthesia, egypt, al-azhar university, faculty of medicine for girls, department of pediatrics surgery, egypt, al-azhar university, faculty of medicine, department of pediatric surgery, egypt, royal commission hospita, department of general surgery, saudi arabia, al- azhar university, faculty of medicine, department of pediatrics, egypt, al-azhar university, faculty of medicine, egypt, al- azhar university, faculty of medicine, department of pediatrics, egypt
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پست الکترونیکی
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medo19@gmail.com
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Authors
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