Tanveer Hussain, Salman Ahmad, Arshad Taqi, Shahida Khwaja.
A Comparison of Equipment Doses of Tramadol and Nalbuphine in Gynecological Laparotomies Postoperatively.
Pak Armed Forces Med J Jan ;66(5):738-41.

Objective: to compare the mean consumption of equipotent doses of tramadol and nalbuphine for first 12 hours of post-operative analgesia, in patients undergoing gynaecological laparotomies. Study Design: Randomized clinical trial. Place and Durration of Study: Hameed Latif Hospital Lahore from 6 months. Materials and Methods: One hundred American society of anaesthesiologists (ASA) I & II, consenting females, ages between 20 and 50 years were divided randomly into two equal groups. All patients were given a loading dose of either tramadol (1.5mg/kg) or nalbuphine (0.15mg/kg) after the induction of anesthesia. Same drug was continued as baseline infusion; tramadol 0.5mg/kg or nalbuphine 0.05mg/kg respectively was given as a bolus whenever the visual analogue scale (VAS) score was ?3. total dose given in bolus was calculated and compared. Time at the instant of first demand of analgesia in postop was also noted in both groups. Results: Mean SD dose of rescue boluses in Tramadol group was 89.26 ± 40.00 mg, while mean of equipotent dose of Nalbuphine group was 134.72 ± 61.81 mg (p<0.001). the difference between groups was statistically significant. Conclusion: Requirement for equipotent doses of analgesic were less in case of tramadol as compared to nalbuphin for treatment of breakthrough pain when both drugs were given as bolus at the commencement of surgery and continued as a continuous infusion postoperatively.

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