Comparison of analgesic effect of tramadol alone and a combination of tramadol and paracetamol in day-care laparoscopic surgery

Background and objective To compare the analgesic efficacy of tramadol alone (1.5 mgkg^-1) with a tramadol (1 mgkg^-1) and paracetamol combination in day-care laparoscopic patients. Methods The analgesic efficacy of intravenous tramadol alone (1.5mgkg^-1) (group T) was compared with a combination of intravenous tramadol (1 mgkg^-1) and oral paracetamol 1 g (group TP) in 60 day-care laparoscopic patients in a prospective randomized double-blind clinical trial in a tertiary care hospital. Intraoperative haemodynamic responses and postoperative visual analogue scores were used to assess the analgesic efficacy. Results Only one patient (in group T) received a single dose of rescue analgesia intraoperatively. The highest pain scores were recorded at 30min postoperatively in both groups, and rescue analgesia was needed in eight patients in group T and in 13 patients in group TP (P = 0.08). The incidence of moderate-to-severe nausea was high in group T(P = 0.001). Conclusion We conclude that reducing the dose of tramadol to 1 mg kg^-1 and combining it with paracetamol 1 g orally decreased the incidence of side effects of tramadol without reducing analgesic efficacy.