Analgesia with paracetamol/tramadol vs. paracetamol/codeine in one Day-Surgery: a randomized open study

G. Alfano*, M. Grieco*, A. Forino, G. Meglio, M.C. Pace, M. Iannotti

*Hospital M. Scarlato, Operative Unit of Anesthesia and Intensive Care, ASL Salerno (Italy); Department of Anesthesiology, Surgical and Emergency Science, 2nd University of Naples (Italy)

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• Anesthesiology

Objectives: The analgesic efficacy of two fixed combinations of tramadol/paracetamol (TP 37.5/325 mg) and codeine/paracetamol (CP 30/500 mg) was compared in 122 patients undergoing one-day surgical procedures (hallux valgus, haemorrhoidectomy, varicectomy and inguinal hernia repair), randomly treated with TP 37.5/325 mg or CP 30/500 mg one tablet after surgery ended, followed by one tablet four times daily for 48 hours.

Methods: Pain was assessed by a Verbal Rating Scale (VRS). Whenever the VRS score was ≥3, the patient was given a “rescue medication” (tramadol 50 mg s.c.). The quality of life (time to return to normal daily activities, nightly rest, appetite, mood, deambulation, and self-care) was assessed in the postoperative period. Patients were asked to give their judgment on the surgical procedure and postoperative outcome.

Results: The results indicate that TP 37.5/325 mg was superior to CP 30/500 mg in terms of higher analgesic efficacy (VSR at 24 hours: CP 30/500, 2.52 ± 0.86 vs. TP 37.5/325, 1.40 ± 0.76; p Conclusions: We conclude that a fixed association of tramadol/paracetamol is a valuable and safe tool for pain management in day hospital surgery, especially whenever any effort is done to reduce the time for hospitalization.

Corresponding Author: Mario Iannotti, MD; e-mail: iannotti.mario@virgilio.it