Zahid Ahmad Hashmi, Ghazala Bashir, Shakeel Ahmad Shah.
Comparison of the efficacy of tramadol hydrochloride versus diclofenac sodium for postoperative pain control in the first twenty four hours.
Ann Pak Inst Med Sci Jan ;2(4):239-42.

Objective: To study the effectiveness of tramadol hydrochloride in post operative pain control and to compare its duration of action and side effects with non steroidal anti- inflammatory drug diclofenac sodium. Study Design: Single blinded randomized controlled trial. Place and Duration: Department of General Surgery, District headquarters teaching hospital, D. I. Khan. Subjects and Methods: 200 patients with moderate to severe post operative pain were randomized to either group A or B without being aware of it. The post operative pain in group A was controlled with single intramuscular injection of 100mg tramadol hydrochloride while in group B it was controlled with 75 mg of diclofenac sodium administered intra- muscularly. Results: Tramadol hydrochloride when compared with diclofenac sodium was found to be more effective analgesic (65% compared to 55%). Analgesia in the fourth post operative hour was significantly higher with tramadol hydrochloride compared with diclofenac sodium. There was no significant difference in the cardio-respiratory parameters in the two groups. Oversedation associated with dizziness and muscle relaxation was observed with tramadol hydrochloride while in case of diclofenac sodium gastrointestinal symptoms like epigastric pain and nausea were recorded. The analgesic effect of 100 mg tramadol hydrochloride lasted up to 24 hours while that of diclofenac sodium lasted 6.8 hours, so multiple injections were required to relieve pain. Conclusion: Tramadol hydrochloride is safer and more effective analgesic for post operative pain as compared to diclofenac sodium. Tramadol hydrochloride offers prolonged analgesia with minimal side effects.

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