Effects of intramuscular and peritonsillar injection of tramadol before tonsillectomy: A double blind, randomized, placebo-controlled clinical trial

Summary Background/aims Our objective was to investigate the efficacy of intramuscular injection and peritonsillar infiltration of tramadol to prevent pain in children undergoing tonsillectomy. Methods In a double-blinded trial, 45 children were randomized into three groups: infiltration anesthesia with tramadol (2 mg kg−1 ) to the peritonsillar area (INF group, n = 15), intramuscular analgesia with tramadol (2 mg kg−1 ) (IM group, n = 15), and the placebo controls (PL group, n = 15). Visual analog scale (VAS) scores for pain assessment, heart rate (HR) and mean arterial pressure (MAP) during and after anesthesia were recorded. Results Mean HR values were higher in INF than PL group at 10th, 20th, and 30th minutes of operation ( P < 0.05). Nine children required analgesics within the first hour after surgery in PL compared to 1 child in INF group ( P = 0.036). VAS scores on awakening were significantly better in INF than PL group ( P = 0.015). The difference between IM and PL groups was not significant for any of the parameters. Conclusion Peritonsillar infiltration with tramadol provided good intraoperative analgesia, less postoperative pain on awakening and lower analgesic requirement within the first hour after surgery.