Postoperative analgesia with tramadol and indomethacin for diagnostic curettage and early termination of pregnancy

Background: The postoperative analgesic effects of rectal indomethacin and tramadol were compared in patients undergoing elective termination of first trimester pregnancy and diagnostic dilatation and curettage. Methods: Eighty-one American Society of Anesthesiologists class I and II women undergoing first trimester termination of pregnancy or diagnostic dilation and curettage were randomly allocated to receive rectal suppositories of either tramadol 100 mg (n = 41) or indomethacin 100 mg (n = 40) 90 min before induction of anesthesia. Pain scores and side effects were evaluated until discharge. Intraoperative anesthetic and postoperative analgesic consumption was also recorded. Intravenous metamizole 1 g was employed for postoperative rescue analgesia. Results: When compared to the indomethacin group, the tramadol group required less intraoperative propofol [136 mg ±28 vs. 160 mg ±35 (P = 0.001)], less rescue analgesia [2.4% vs. 22% (P = 0.005)] and lower visual analogue pain scores [2.4 ±8 vs. 23 ±22 (P = 0.005)]. The incidence of postoperative nausea and vomiting was similar in both groups. Conclusion: When compared to indomethacin 100 mg, preoperative administration of tramadol 100 mg provides superior postoperative analgesia with minimal adverse effects.