Effectiveness of combination tramadol and tenoxicam versus transdermal fentanyl patches in post-laparotomy

Sarıçiçek V., Köni Ç. K.

Eurasian clinical and analytical medicine (Online), cilt.14, sa.1, ss.10-14, 2026 (TRDizin)

Özet

Aim: This study aimed to compare postoperative pain management protocols and to identify the regimen that minimizes morphine consumption in patients receiving a transdermal fentanyl (TDF) patch, with or without adjunctive tramadol and/or tenoxicam. Materials and Methods: Eighty patients were enrolled in this randomized study. All patients received a TDF patch (50 μg / h) applied 12 hours before surgery, and patient-controlled analgesia with morphine was initiated in the post-anesthetic care unit. Patients were divided into four groups (n = 20 each): Group 1 received no additional analgesia; Group 2 received tramadol 100 mg four times daily; Group 3 received tenoxicam 20 mg once daily; and Group 4 received both tramadol (100 mg four times) and tenoxicam (20 mg once). Demographic data, hemodynamic parameters, Ramsay Sedation Scale (RSS), resting and mobilization visual analog scale (VAS) scores, respiratory rate, oxygen saturation, side effects, and morphine consumption were recorded over 24 hours. Results: Morphine consumption differed significantly between groups at each 6-hour interval, with Groups 1 and 4 showing significantly different consumption compared with the other groups (p < 0.05). Resting VAS scores were lower in Group 1 compared with Group 4 at the 2nd and 4th hours (p < 0.05). Oxygen saturation values were significantly lower in Group 1 at the 1st and 2nd postoperative hours compared with Groups 2 and 4 (p < 0.05). Combined tramadol and tenoxicam administration resulted in lower pain scores at multiple time points. Discussion: Tramadol or tenoxicam alone provided comparable postoperative analgesia, whereas their combined use resulted in more effective pain control without increasing complication rates.