Intravenous Tramadol versus Nalbuphine For Postoperative Pain Control In Cholecystectomy: A Comparative Study

Abstract

Background: Effective postoperative pain management is crucial for patient recovery and satisfaction. This study compared the analgesic efficacy and safety of intravenous Nalbuphine and Tramadol in patients undergoing elective cholecystectomy.

Methods: A cross-sectional study was conducted at Lady Reading Hospital, Peshawar, from July to December 2025. A total of 60 patients (ASA I–II), aged 18–60 years, were randomly assigned to receive either intravenous Nalbuphine (0.2 mg/kg, n = 30) or Tramadol (1 mg/kg, n = 30) at induction. Postoperative pain was assessed at 2 and 4 hours using the Visual Analogue Scale (VAS), and rescue analgesia and adverse effects were recorded. Data were analyzed using Chi-square tests, with p < 0.05 considered significant.

Results: At the 2nd postoperative hour, 70% of patients in the Nalbuphine group experienced mild pain compared to none in the Tramadol group (p < 0.001). At the 4th hour, all Nalbuphine patients reported mild pain, while only 50% of Tramadol patients did (p < 0.001). Rescue analgesia was required in 38.3% of patients, predominantly in the Tramadol group. Adverse effects were mild, with 25% experiencing nausea and 13.3% vomiting; 61.7% reported no side effects.

Conclusion: Nalbuphine provides superior and sustained postoperative analgesia compared to Tramadol, with a lower need for rescue analgesia and minimal adverse effects, making it a safe and effective option for pain management after elective cholecystectomy.