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347433

The effect of intraoperative tramadol on post-operative opioid requirements after laparoscopic sleeve gastrectomy for morbidly obese patients: A retrospective multicentric cohort

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Last updated: 05 Jan 2025

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Abstract

Background: This study aimed to compare the efficacy and safety of combined intraoperative tramadol with pethidine versus pethidine alone and to assess their impact on post-operative pethidine requirements after laparoscopic sleeve gastrectomy (LSG).
Methods and Results: This multicenter cohort research included 400 patients with morbid obesity who had LSG between January 2021 and December 2022. The patients included in the study were allocated to one of two treatment groups that were not randomized. Group A received only 1 mg/kg of pethidine before extubation. , while Group B got 1 mg/kg tramadol given when the surgeon started a gastric division with 1 mg/kg of pethidine before extubation. Doses were based on the patient's ideal body weight.The mean VAS pain score at 1, 3, 6, 12, and 24h after LSG was significantly reduced in group B (4.2, 2.89, 2.03, 1.69, and 0.26, respectively) compared to group A (5.1, 4.16, 3.21, 2.78, and 0.44). Post-operative nausea and vomiting (PONV) were higher in group A at 3 and 6 h after LSG. Opioid consumption in the post-operative period was less in Group B than in Group A. There was a significant reduction in the requirement for on-demand metoclopramide and ondansetron in group B. Oxygen desaturation (<92) significantly developed in group A after surgery and was managed using an oxygen mask. Post-operative bradycardia was significantly observed in group B after LSG.
Conclusions: Intraoperative tramadol with pethidine provides superior post-operative analgesia and safety over Intraoperative pethidine alone.

DOI

10.21608/asja.2024.250571.1014

Keywords

Laparoscopic sleeve gastrectomy, multiple analgesia protocol, Obesity, Post-operative nausea and vomiting, post-operative pain. tramadol

Authors

First Name

Aly E.

Last Name

Rashad

MiddleName

-

Affiliation

lecturer of anesthesia and surgical ICU and pain medicine, Mansoura University, Egypt

Email

alydawood441@yahoo.com

City

-

Orcid

0000-0002-4262-0553

First Name

emad

Last Name

el hefnawy

MiddleName

-

Affiliation

assistant professor of anaethesia and surgical ICU and Pain Medicine, Mansoura University, Egypt.

Email

emadhefnawy@yahoo.com

City

-

Orcid

0000-0001-8699-5050

First Name

Mohamed

Last Name

Elmorshedi

MiddleName

A.

Affiliation

lecturer of anaethesia and surgical ICUand Pain Medicine, Mansoura University, Egypt.

Email

mhmdmorshedi@yahoo.com

City

-

Orcid

0000-0002-0984-0853

First Name

Yousif

Last Name

Abuyousif

MiddleName

Abdelmonem

Affiliation

Wadi Aldawaser Armed Forces Hospital, Kingdom of Saudi Arabia.

Email

yousifabuyousif4@gmail.com

City

-

Orcid

0000-0003-3190-4179

First Name

Ali

Last Name

Salem

MiddleName

-

Affiliation

assistant professor of Anesthesia and Surgical ICU and Pain Medicine, Mansoura University, Egypt.

Email

drali_git@mans.edu.eg

City

-

Orcid

-

First Name

Ayman

Last Name

El Nakeeb

MiddleName

-

Affiliation

professor of Anesthesia and Surgical ICU and Pain Medicine, Mansoura University, Egypt.

Email

elnakeebayman@yahoo.com

City

-

Orcid

0000-0002-3002-6872

First Name

Ahmed

Last Name

Zaid

MiddleName

-

Affiliation

Wadi Aldawaser Armed forces hospital, Kingdom of Saudi Arabia.

Email

prof.ahmedzaid@gmail.com

City

-

Orcid

0000-0002-6991-9395

First Name

Hassan

Last Name

Aldossary

MiddleName

Maged

Affiliation

Wadi Aldawaser Armed forces hospital, Kingdom of Saudi Arabia.

Email

addossary_1@hotmail.com

City

-

Orcid

0000-0002-5225-7137

First Name

Mohammed

Last Name

Mohammed

MiddleName

N.

Affiliation

Department of Anesthesia and Surgical ICU and Pain Medicine, Mansoura University, Egypt.

Email

moh_nashaat@mans.edu.eg

City

-

Orcid

0000-0002-0194-2556

Volume

16

Article Issue

1

Related Issue

46864

Issue Date

2024-01-01

Receive Date

2023-11-22

Publish Date

2024-01-01

Page Start

1

Page End

11

Print ISSN

1687-7934

Online ISSN

2090-925X

Article File

ASJA_Volume 16_Issue 1_Pages 1-11.pdf

PDF . 511.5kB

Link

https://asja.journals.ekb.eg/article_347433.html

Detail API

https://asja.journals.ekb.eg/service?article_code=347433

Order

347,433

Type

Original Article

Type Code

2,871

Publication Type

Journal

Publication Title

Ain-Shams Journal of Anesthesiology

Publication Link

https://asja.journals.ekb.eg/

MainTitle

The effect of intraoperative tramadol on post-operative opioid requirements after laparoscopic sleeve gastrectomy for morbidly obese patients: A retrospective multicentric cohort

Details

Type

Article

Created At

20 Dec 2024