WORLD JOURNAL OF ADVANCE
HEALTHCARE RESEARCH

Ahmed A. Eeda*, Mohanad Abdul Kareem Hilal, Haydar Samir Abdullatif

ABSTRACT

Background: Postoperative pain management remains inadequate for many patients despite advances in analgesics, as it can lead to complications like respiratory issues, cardiovascular strain, thromboembolism, and stress responses. Opioids such as tramadol provide potent relief but cause side effects including nausea, vomiting, and respiratory depression, prompting research into combinations with paracetamol for better efficacy and safety. Patients and Methods: This cross-sectional study at Al-Hussein Teaching Hospital (January-December 2025) enrolled 150 adults (18-65 years, ASA I-II) undergoing elective abdominal surgery under general anesthesia, randomized into two groups of 75: Group I received 1 mg/kg IV tramadol + 1 g paracetamol; Group II received 1.5 mg/kg IV tramadol. Pain was assessed via VAS at 2, 6, 12, and 24 hours postoperatively; data analyzed with SPSS v26 (p≤0.05 significant). Results: Baseline demographics (age, gender, BMI, ASA, surgery type/duration) were comparable between groups (p>0.05). The combination group showed significantly lower VAS scores: 5.3±0.8 vs. 6.12±0.7 (2h, p=0.001), 5.2±1.4 vs. 5.8±1.0 (6h, p=0.001), 2.3±0.9 vs. 2.8±1.0 (12h, p=0.022), 1.2±0.8 vs. 2.1±0.8 (24h, p=0.003). Conclusion: Low-dose tramadol-paracetamol combination provides superior postoperative analgesia compared to higher-dose tramadol alone, with lower pain scores across all time points, aligning with prior studies showing reduced complications like nausea.

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