Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine

Thomas Engelhardt, E. Steel, G. Johnston, D. Y. Veitch

    Research output: Contribution to journalArticlepeer-review

    87 Citations (Scopus)


    Background: Pain control for paediatric patients undergoing tonsillectomy remains problematic. Tramadol is reported to be an effective analgesic and to have a side-effect profile similar to morphine, but is currently not licensed for paediatric use in the UK.
    Methods: We conducted a prospective, double-blind, randomized controlled trial in children who were scheduled for elective tonsillectomy or adenotonsillectomy at the Royal Aberdeen Children Hospital. Following local ethics committee approval and after obtaining a drug exemption certificate from the Medicines Licensing Agency for an unlicensed drug, we recruited 20 patients each into morphine (0.1, tramadol (1 and tramadol (2 groups. These drugs were given as a single injection following induction of anaesthesia. In addition, all patients received diclofenac (1 rectally. The postoperative pain scores, analgesic requirements, sedation scores, signs of respiratory depression and nausea and vomiting, as well as antiemetic requirements, were noted at 4-h intervals until discharge.
    Results: There were no statistically significant differences in age, weight, type of operation or induction of anaesthesia, 4-h sedation and pain scores and further analgesic requirements. There were no episodes of respiratory depression. Morphine was associated with a significantly higher incidence of vomiting following discharge to the wards (75% versus 40%, P =0.03) compared with both tramadol groups.
    Conclusions: Tramadol has similar analgesic properties, when compared with morphine. The various pharmaceutical presentations and the availability as a noncontrolled substance may make it a useful addition to paediatric anaesthesia if it becomes licensed for paediatric anaesthesia in the UK.

    Original languageEnglish
    Pages (from-to)249-252
    Number of pages3
    JournalPediatric Anesthesia
    Issue number3
    Publication statusPublished - Mar 2003


    • tramadol
    • morphine
    • adenotonsillectomy
    • pain relief
    • children
    • double blind
    • analgesia
    • anesthesia
    • placebo
    • nausia
    • combination
    • paracetamol
    • diclofenac


    Dive into the research topics of 'Tramadol for pain relief in children undergoing tonsillectomy: a comparison with morphine'. Together they form a unique fingerprint.

    Cite this