INJECTABLE TRAMADOL VS DICLOFENAC AS AN ANALGESIC FOR POST-OPERATIVE HYSTERECTOMY

Dr. Namrata Rajendra Pawar*, Dr. Yogita Surendra Karandikar and Dr. Uma Anand Bhosale

ABSTRACT

Background: Postoperative pain may be a significant reason for delayed discharge from hospital, increased morbidity, and reduced patient satisfaction. Nowadays opioids are the mainstay in the treatment of acute postoperative pain. Tramadol is an atypical opioid having an additional mechanism by inhibitory reuptake of NA and 5HT. But opioids produce side effects like nausea, vomiting, sedation, pruritis. Diclofenac is a non-selective NSAIDs with good tissue permeability. NSAIDs are particularly effective in cases of somatic inflammatory pain. Objectives: We conducted this study to compare the efficacy of Injection tramadol and Injection diclofenac as an analgesic for post-operative patients undergoing Hysterectomy. Methods: This was an open-label prospective study that included 60 female patients undergoing hysterectomy aged 20 years and above. Randomly allocated 30 patients were given Tramadol 50 mg IV three times a day and the rest 30 patients were given Diclofenac 75mg IV two times a day. Post-operative pain scores were recorded using the Visual Analog Scale (VAS) and Facial Rating Scale (FRS) at 6,12,24 and 48 hrs respectively and the ASSIST scale was recorded at 24hrs. Statistical analysis was done using unpaired t-test. Results: The mean pain score was found less in the diclofenac group compared to the tramadol group at all intervals by VAS and FRS (p<0.05). As per ASSIST, patient and caregiver satisfaction score was better in the diclofenac group. Nausea and dizziness were more commonly reported in the tramadol group. Conclusion: Diclofenac provides effective and better analgesia in acute post-hysterectomy pain than tramadol with fewer adverse effects.

Keywords: Postoperative Pain, Tramadol, Diclofenac, VAS, FRS, ASSIST.