Comparison of morphine and tramadol by patient-controlled analgesia for postoperative analgesia after tonsillectomy in children

Summary Background : Tramadol is an alternative to other opioids for postoperative pain management. This prospective, randomized, double‐blind study was designed to compare the analgesic efficacy of patient‐controlled tramadol with patient‐controlled morphine for postoperative pain after tonsillectomy in children. Method : Sixty patients were allocated randomly to receive a patient‐controlled analgesia (PCA) with either tramadol (T) or morphine (M), in a double‐blind randomized study. When surgery was completed and hemostasis achieved, a standardized loading dose (0.1 mg·kg−1 in group M, or 1 mg·kg−1 in group T) was given. Thereafter, the children helped themselves to bolus doses (morphine (0.02 mg·kg−1) or tramadol (0.2 mg·kg−1) with lockout times of 10 min without time limit via a PCA device. Scores for pain, sedation, nausea, and the bolus and total PCA doses, hemodynamic parameters and side effects were recorded at 5, 15, 30 min and 1, 2, 4, 6 and 24 h during PCA administration. Results : Pain scores decreased significantly with time in both groups (P