A prospective comparative study between tramadol, lidocaine and placebo in subcutaneous wound infiltration for postoperative pain relief in cesarean section

Sweed, Amr Sobhy; Khlaiq, Shahida; Shehata, Hanan; Taema, Mohamed I

doi:10.21608/egyfs.2023.297235

A prospective comparative study between tramadol, lidocaine and placebo in subcutaneous wound infiltration for postoperative pain relief in cesarean section

Document Type : Original Article

Authors

¹ Lecturer of Obstetrics and Gynecology Faculty of medicine, Ain Shams University, Cairo-Egypt

² Department of obstetrics and gynecology, Faculty of medicine, King Saud University, Riyadh, Saudi Arabia

³ Department of obstetrics and gynecology, Ain shams university. Cairo Egypt

10.21608/egyfs.2023.297235

Abstract

Background: As the rate of cesarean section (CS) is increasing rapidly, the need of postoperative analgesia is increasingly required. Aim: to evaluate the effect of tramadol injection at incision site before closure of the skin in patients undergoing cesarean section on post-operative pain and the need of analgesics in comparison to lidocaine.
Methods: this study was conducted in 2 hospitals in kingdom of Saudi Arabia in period of January 2021 till June 2021, ninety women undergoing cesarean section delivery were divided into 3 groups to receive tramadol, lidocaine or placebo subcutaneously before closing of skin in CS. using visual analogue scale (VAS), Pain was assessed at 6, 12 and 24 h post-operative.
Results: Pain (VAS scores) were significantly lower in the tramadol group in comparison to the other two groups at 6 h (p<0.001), and 12 h (p<0.01). VAS score at 24 h was significantly lower in the Tramadol group compared with Placebo group (p<0.01) and was comparable to Lidocaine group. Non statistically significant difference between VAS scores in Lidocaine group and Placebo was. Time to first analgesic demand was significantly longer in Tramadol group; 2.58±0.93 versus 2.47±0.82 versus 5.97±3.19 hours in the Placebo, Lidocaine and Tramadol group respectively, p <0.001.
Conclusion : local wound injection with tramadol resulted in significantly lower pain scores, But longer time to first analgesic request and lower overall cumulative 24-hour consumption of analgesics. Lidocaine didn’t add any analgesic effect over placebo. tramadol wound injection in CS is a good choice for post-operative analgesia.

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