Tramadol Wound Infiltration Is Not Different From Intravenous Tramadol in Children: A Randomized Controlled Trial

J Clin Anesth. 2016 Feb;28:62-6. doi: 10.1016/j.jclinane.2015.08.009. Epub 2015 Oct 2.


Study objective: The purpose of this trial was to assess if tramadol wound infiltration is superior to intravenous (IV) tramadol after minor surgical procedures in children because tramadol seems to have local anesthetic-like effect.

Design: Randomized double-blind controlled trial.

Setting: Postanesthesia care unit.

Patients: Forty children, American Society of Anesthesiologists physical status I or II, scheduled to elective inguinal hernia repair.

Interventions: Children were randomly distributed in 1 of 2 groups: IV tramadol (group 1) or subcutaneous infiltration with tramadol (group 2). At the end of the surgery, group 1 received 2 mg/kg tramadol (3 mL) by IV route and 3-mL saline into the surgical wound; group 2 received 2 mg/kg tramadol (3 mL) into the surgical wound and 3-mL saline by IV route.

Measurements: In the postanesthesia care unit, patients were evaluated for pain intensity, nausea and vomiting, time to first rescue medication, and total rescue morphine and dipyrone consumption.

Main results: Pain scores measured during the postanesthesia recovery time were similar between groups. Time to first rescue medication was shorter, but not statistically significant in the IV group. The total dose of rescue morphine and dipyrone was also similar between groups.

Conclusions: We concluded that tramadol was effective in reducing postoperative pain in children, and there was no difference in pain intensity, nausea and vomiting, or somnolence regarding IV route or wound infiltration.

Keywords: Hernioplasty; Infiltration anesthesia; Intravenous administration; Postoperative pain; Tramadol.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Intravenous
  • Analgesics, Opioid / administration & dosage*
  • Analgesics, Opioid / pharmacokinetics*
  • Child
  • Child, Preschool
  • Double-Blind Method
  • Female
  • Hernia, Inguinal / surgery
  • Herniorrhaphy / methods
  • Humans
  • Injections, Intralesional
  • Male
  • Pain Measurement
  • Pain, Postoperative / drug therapy
  • Postoperative Care
  • Postoperative Nausea and Vomiting / epidemiology
  • Tramadol / administration & dosage*
  • Tramadol / pharmacokinetics*


  • Analgesics, Opioid
  • Tramadol