Local Tramadol Infltration Professional Med J 2021;28(7):1022-1027. www.theprofesional.com 1022 The Professional Medical Journal www.theprofesional.com The effect of local tramadol infltration in post pyelolithotomy pain. ORIGINAL PROF-0-5742 Haq Dad Durrani 1 , Sairah Sadaf 2 , Syed Aushtar Abbas Naqvi 3 , Manzoor Hussain Bajwa 4 , Mirza Shakeel Ahmad 5 , Muhammad Khalid 6 ABSTRACT… Objective: To compare the analgesic effcacy of tramadol wound infltration with normal saline wound infltration in patients undergoing Pyelolithotomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesia, ICU and Pain Medicine, DG Khan Teaching Hospital, Dera Ghazi Khan. Period: July 2019 to September 2019. Material & Methods: Total 60 patients were included in this study. There were 30 patients in whom normal saline was used for wound infltration and in other 30 patients tramadol was used for wound infltration. Analgesic outcomes were noted in terms of Numerical Rating Scale (NRS) of pain in the recovery room, at 06 hours and 24 hours after surgery, mean time of frst rescue analgesia and total dose of tramadol within 24 hours after surgery. Results: Mean pain score in the recovery room was 5.20±2.10 in saline group versus 2.60±1.13 in tramadol group (p<0.001). Mean post-operative pain score after 06 hours of surgery was 5.43±1.45 in saline group versus 2.30±1.05 in tramadol group (p<0.001). Pain score was 3.63±1.40 in saline group versus 1.67±0.80 in tramadol group after 24 hours of surgery (p<0.001). Mean time of frst rescue analgesia was 6.16±2.47hours in tramadol group versus 0.97±1.46hours in saline group (p<0.001). Total dose of tramadol used for analgesia within 24 hours after surgery was 56.67±70.38mg in tramadol group versus 253.33±73.02mg in saline group (p<0.001). Conclusion: Wound infltration with tramadol provides better analgesia as compared to normal saline in patients undergoing Pyelolithotomy. Key words: Normal Saline, Pyelolithotomy, Tramadol, Wound Infltration. 1. MBBS, DA, FCPS, M.Sc. (Pain Medicine) Professor Anesthesiology, Pain and Intensive Care Sahara Medical College Narowal. 2. MBBS, FCPS Associate Professor Anesthesia, Pain and Intensive Care Sheikh Zayed Medical College, Rahim Yar Khan. 3. MBBS, FCPS Assistant Professor Anesthesiology, Pain and Intensive Care, D.G. Khan Medical College, Dera Ghazi khan. 4. MBBS, DA, FCPS Assistant Professor Anesthesia, M. Islam Medical and Dental College, Gujranwala. 5. MBBS, FCPS Associate Professor Anesthesia, D.G. Khan Medical College, Dera Ghazi Khan. 6. MBBS, FCPS Associate Professor Urology D.G. Khan Medical College, Dera Ghazi Khan. Correspondence Address: Professor Haq Dad Durrani Department Of Anesthesiology Pain and Intensive Care, Sahara Medical College Narowal. drhaqdad@szmc.edu.pk profhaqdad@gmail.com Article received on: 21/07/2020 Accepted for publication: 17/11/2020 Article Citation: Durrani HD, Sadaf S, Naqvi SAA, Bajwa MH, Ahmad MS, Khalid M. The Effect of Local Tramadol Infltration in Post Pyelolithotomy Pain. Professional Med J 2021; 28(7):1022-1027. https://doi.org/10.29309/TPMJ/2021.28.07.5742 INTRODUCTION Pain is defned as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage”. 1 Most common adverse effects of pain are hypertension, tachycardia, increased myocardial irritability, increased minute ventilation, decreased tidal volume, increased CO2 production, enhanced sympathetic tone and excessive release of catabolic hormones. 2 In our region, renal stones are quite common. Pyelolithotomy is a procedure in which stones are removed from renal pelvis surgically. 3 Most commonly it is done under general anaesthesia and after recovery, pain is the most common complaint. Various modalities are in use for control of postoperative pain like multimodal analgesia, skin infltration by local anaesthetic solution, local nerve blocks and continuous infltration of surgical site. As a component of multimodal analgesia, infltration of local anesthetic at the surgical site is widely practiced. Bupivacaine 0.25% is the commonest local anaesthetic which is used for this purpose. But due to its cardio toxic effects, various other drugs have been tried for local wound infltration as sole drug. 4,5 Tramadol, a weak opioid is administered for moderate to severe pain. Several studies have reported its local anesthetic effect. 6,7 For pain relief after arthroscopy of knee joint, tramadol has been administered as intra articular injection. 8 Khazai compared pain relief after wound infltration with tramadol and normal saline; they found that https://doi.org/10.29309/TPMJ/2021.28.07.5742