Overview
Tramadol is commonly used postoperatively due to its ease of administration, but it carries several risks, including interindividual variability, drug interactions, neuropsychiatric risks in elderly patients, and long-term dependence. Although its analgesic efficacy is comparable to that of strong opioids, its role in a multimodal analgesia strategy remains insufficiently studied. Research tailored to current clinical practices is needed to accurately assess its tolerance profile.
Eligibility
Inclusion Criteria:
- Age ≥18 years
- Patient undergoing scheduled laparoscopic abdominal surgery lasting an estimated 2 hours or more.
- Patient affiliated to the social security system.
- Patient signature of consent to participate in the study
Exclusion Criteria:
- Allergy or intolerance to any of the following medicines: paracetamol, nefopam, ketoprofen, tramadol, morphine, Sufentanil, lidocaine, propofol, ketamine, dexamethasone and droleptan.
- Contraindications to any of these medicines: paracetamol, ketoprofen, nefopam, tramadol, morphine, Sufentanil, lidocaine, propofol, ketamine, dexamethasone and droleptan (see Summaries of Product Characteristics).
- Chronic use of monoamine oxidase inhibitors or CYP 450 2D6 inhibitors
- Chronic use of level 2 or 3 analgesics preoperatively
- Ambulatory surgery
- Surgery requiring post-operative admission to an intensive care unit.
- Patients on long-term oxygen therapy
- Patients suffering from psychiatric pathologies.
- Patient suffering from neurodegenerative pathologies
- Patient for whom self-assessment of pain using an NRS (0-10) cannot be carried out (language barrier, etc.)
- Pregnant or breast-feeding woman
- Patient under guardianship or deprived of liberty.
