The efficacy of pre-emptive tramadol in orthopaedic day-surgery

It has been suggested that there may be some advantage in pre-emptive administration of analgesics, which may be of some relevance in day-surgery. Post-operative pain control is often difficult due to the reluctance to use potent analgesics, whose side effects include nausea and vomiting, which are an important cause of delayed discharge. In order to test the potential beneficial effects of pre-emptive analgesia, 110 day-surgery patients were randomly allocated to receive either pre-emptive tramadol or a placebo pre-operatively. Per and postoperative complications were recorded following administration of a standard anaesthetic, comprising intravenous induction with propofol and maintenance with isoflurane. Post operative analgesia and anti-emetics were administered as required. Patients who received tramadol had a slightly lower incidence of postoperative pain, but at the expense of increased nausea; all differences were not significant. © 2004 Elsevier B.V. All rights reserved.