Analgesic efficacy of tramadol 2 mg kg(-1) for paediatric day-case adenoidectomy

We studied the analgesic efficacy of tramadol 2 mg kg(-1) for post-operativ e analgesia after daycase adenoidectomy in children aged 1-3 yr. Eighty chi ldren were allocated randomly to receive tramadol 2 mg kg(-1) i.v. or place bo immediately after induction of anaesthesia. Anaesthesia was induced with alfentanil 10 mug kg(-1) and propofol 4 mg kg(-1) followed by mivacurium 0 .2 mg kg(-1) for tracheal intubation. Anaesthesia was continued with sevofl urane in nitrous oxide and oxygen. All children were given ibuprofen rectal ly at approximately 10 mg kg(-1) before the start of surgery. Post-operativ e pain and recovery assessments were performed by a nurse blinded to the an algesic treatment using the Aldrete recovery score, the pain/discomfort sca le and measurement of recovery times. Rescue medication (pethidine in incre ments of 5 mg i.v,) was administered according to the pain scores. A post-o perative questionnaire was used to evaluate the need for analgesia at home up to 24 h after operation. Rescue analgesic at home was rectal or oral ibu profen 125 mg. Children in the tramadol group required fewer pethidine dose s than those in the placebo group (P=0.014). Forty-five per cent of childre n receiving tramadol did not require post-operative analgesia at all compar ed with 15% of children receiving placebo (P=0.003). Recovery times and the incidence of adverse effects were similar in the two groups in the recover y room and at home. The requirement for rectal ibuprofen at home did not di ffer between groups.