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Ketoprofen is more effective than tramadol for analgesia during early recovery after tonsillectomy in children
According to a study from Finland, "Pain following tonsillectomy is often intense. Nonsteroidal anti-inflammatory drugs and opioids are effective, but both can cause adverse effects. Tramadol may be a viable alternative for post-tonsillectomy pain."
H. Antila and colleagues, Turku University, explained, "This study was designed to compare the analgesic effects of ketoprofen and tramadol during the early recovery period after tonsillectomy. Forty-five ASA class I children (9-15 years) were randomized to receive either saline, ketoprofen (2 mg/kg) or tramadol (1 mg/kg) after induction of anesthesia. Upon completion of surgery, the study treatment was continued as a 6 h intravenous (i.v.) infusion of another dose of saline, ketoprofen (2 mg/kg) or tramadol (1 mg/kg). Postoperatively, each patient received rescue analgesia with patient-controlled analgesia (PCA) device programmed to deliver 0.5 mc g/kg bolus doses of fentanyl."
They continued, "Postoperative pain was assessed using Visual Analog Scale (VAS) during swallowing. Intraoperative blood loss was measured. The total number of requests of PCA-fentanyl was significantly less in ketoprofen group compared with tramadol and placebo groups (p=.035 and p=.049, respectively, in pairwise comparisons) and the VAS scores for pain were significantly lower in ketoprofen group compared with tramadol (p=.044) or placebo groups (p=.018) during the first six postoperative hours. Measured intraoperative blood loss was greater in ketoprofen-treated patients than in those receiving placebo (p=.029)."
The researchers concluded, "A dose of 4 mg/kg of i.v. ketoprofen provided good pain relief with moderate supplemental PCA-fentanyl requirements during the first six postoperative hours after tonsillectomy in children whereas the effects of 2 mg/kg of i.v. tramadol did not differ from those of placebo."