Comparison of local anaesthetic effects of tramadol with prilocaine for minor surgical procedures

Background. Recent studies have shown that a local anaesthetic action of tramadol 5% was able to induce a sensory block to pinprick, touch, and cold similar to that of lidocaine 1%. The aim of this study was to compare the local anaesthetic effects of tramadol hydrochloride with prilocaine. Methods. Sixty ASA I or II patients, undergoing excision of the cutaneous lesions under local anaesthesia, were included in the study. Patients were randomly assigned to receive either 1 ml of tramadol 5% (Group T, n=30) or 1 ml of prilocaine 2% (Group P, n=30) intradermally, in a double-blinded fashion. The degree of the burning sensation and pain at the injection site was documented. Sensory block was assessed 1 min after injection. The patient was asked to report the degree of sensation and to grade touch and pinprick sensation. Two minutes after drug administration, incision was performed and intensity of pain, felt by the patient was evaluated on a four-point scale (0-3). Any local adverse effects were recorded. Results. There was no difference in the quality of block between the two groups. Side effects were noted in both groups with a significant increase in the incidence of local reaction (rash) in Group T (seven patients) when compared with Group P (one patient) (P<0.05). Seven patients in Group T vs four patients in Group P complained of burning at the injection site (P>0.05). Conclusions. Intradermal tramadol 5% can provide a local anaesthesia similar to the prilocaine but the incidence of local adverse effects is higher.