Comparison between local anesthetic effects of Tramadol and Lidocaine used subcutaneously in minor surgeries

Abstract Backgroung: Recent studies have shown that Tramadol has local anesthetic effects in addition to its classical analgesic effect. In this study, the local anesthetic and postoperative analgesic effects of Tramadol were compared with those of Lidocaine in minor surgeries under local anesthesia. If the efficacy of Tramadol in this regard is proven, it will make considerable advances in the local anesthetic area. Materials and methods: In this random double-blinded clinical trial study, seventy patients aged between 20 to 50 in ASA physical status of I and II underwent subcutaneous block for minor surgeries. The patients were randomly assigned to receive either 2 mg/kg of Tramadol (group T, n=35), or 1 mg/kg of Lidocaine 2% (group T, n=35) subcutaneously. The mean degrees of pain sensation were recorded on the VAS (visual analogue scale 0-10) during injection, incision, and every 15 minutes at the 15th, 30th, and 45th minutes after the incision, and then every two hours at the 2nd, 4th, and 6th hours postoperatively in the ward. The data were analyzed using repeated measures and Chi-square. When the VAS of pain during surgery exceeded 4, an additional 0.5 mg/kg of the study drug was injected. The patients with the VAS of 4 or more were advised to take Acetaminophen 325 mg if necessary. Results: There were no significant differences between the pain score of the two groups during injection, incision, surgery, and postoperative time (p=0.181). Additionally, no significant differences were found in local skin reaction (p=0.104), bleeding quantity (p=0.112), additional dose of local anesthetic (p=0.48), and incidence of vomiting (p=0.114). The incidence of nausea (0 %) in group L and (22.8%) in group T, showed a statistically significant difference (p=0.002). In group L, need for Acetaminophen to control their pain was higher than in group T. Conclusion: Tramadol 2 mg/kg has equal local anesthetic and postoperative analgesic effects like Lidocaine 1 mg/kg for minor surgeries performed subcutaneously. Therefore, it is recommended that Tramadol can be used as an alternative drug to Lidocaine in local anesthesia because it is able to decrease the demand for postoperative analgesics.