Does pre-emptive single dose intravenous tramadol produce a safe and effective postoperative analgesia?

Randomized, placebo controlled, single blinded clinical trial of pre-emptive intravenous tramadol 1 mg/kg in combination with IV midazolam in patients with dental fear. A “Pain diary” evaluates the efficacy. The safety is evaluated perioperative monitoring (SpO₂ and BP).

Pain scored by VAS showed no differences between the groups. It took longer time to first rescue pill in tramadol vs. control group (157 vs. 110 min, p = 0.049). Desaturation (SpO₂ < 90%) was more commonly found in tramadol vs. placebo and control (p < 0.01). Increasing systolic blood pressure in the control group. Diastolic blood pressure decrease in tramadol and placebo groups. In the tramadol group, we saw more frequently mild side effects.

Tramadol gave no reduction in postoperative pain but an increased frequency of desaturation and side effects. Other drugs or other doses ought to be tried for this kind of postoperative pain management.