The addition of tramadol to the standard of IV acetaminophen and morphine infusion for postoperative analgesia in neonates offers no clinical benefit: A randomized placebo-controlled trial

Abstract

Background: Tramadol is used following neonatal cardiac and general surgery. However, its ability to opioid-spare or facilitate earlier extubation in postoperative neonates is unquantified. Objective: This randomized placebo-controlled trial aimed to assess whether tramadol's addition to standard analgesia resulted in earlier extubation or reduced analgesic/sedative requirements in postsurgical neonates. Methods: Neonates born ≥32 weeks postmenstrual age received either tramadol [T] 2 mg·kg-1 or placebo [P] 6-hourly for up to 5 days postthoracoabdominal surgery in addition to morphine (commenced at 20 mcg·kg-1·h-1) and 6-hourly IV acetaminophen. Time to extubation, morphine and midazolam amo..