Tramadol or Nalbuphine; Which One is Superior for Analgesia in Post-Operative Period after Percutaneous Nephrolithotomy

Muhammad Sheraz  Javed; Ghulam Mehboob  Subhani; Muhammad  Akmal; Muhammad Irfan  Munir; Safdar Hassan  Javed

doi:10.29054/apmc/2021.1062

Muhammad Sheraz Javed Senior Registrar, Department of Urology, DHQ Hospital, Faisalabad Pakistan
Ghulam Mehboob Subhani Professor & Head, Department of Urology & Kidney Transplantation, Allied & DHQ Hospitals / Faisalabad Medical University, Faisalabad Pakistan
Muhammad Akmal Assistant Professor, Department of Urology & Kidney Transplantation, Faisalabad Medical University, Faisalabad Pakistan
Muhammad Irfan Munir Assistant Professor, Department of Urology & Kidney Transplantation, Faisalabad Medical University, Faisalabad Pakistan
Safdar Hassan Javed Professor & Head, Department of Urology, Independent Medical College, Faisalabad Pakistan

DOI: https://doi.org/10.29054/apmc/2021.1062

Keywords: Per-cutaneous nephrolithotomy, Tramadol, Nalbuphine

Abstract

Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.