Purpose
The aim of the study is to investigate the effect of tramadol abuse on postoperative pain control in patients undergoing paravertebral block following thoracotomy.
Patients and methods
Patients undergoing paravertebral block following thoracotomy were consecutively recruited and were divided into two groups: group T included patients with a history of chronic tramadol abuse and group N included patients with no history of any substance abuse (=50 in each). Analgesic doses, vital signs, and the visual analog scale were evaluated for the first 3 days postoperatively. Complications and need for additional analgesic agents were also scrutinized.
Results
There were no differences in clinical or surgical details between the groups, but patients in group T needed significantly higher doses of analgesics following surgery (<0.05). This was more so for fentanyl (<0.01). Despite that, visual analog scale scores were higher with less pain control compared with group N (<0.05).
Conclusion
Chronic tramadol abuse has a significant effect on postoperative pain control following thoracotomy. This information can be used to develop better postoperative management plans and refine expectations of both the patients and their health-care providers leading to better clinical outcomes and reduced morbidity.