Critique of Systematic Research Review
Introduction
The title of the article is “Tramadol for postoperative pain treatment in children”. The main purpose of the article is to assess the effectiveness and side effect profile of tramadol for postoperative pain relief in children and adolescents undergoing different surgical procedures. Tramadol is an opioid pain medication, which is used to treat moderate to moderately severe pain. Tramadol is marketed as a racemic mixture of both R- and S- stereoisomers as well as combined with paracetamol as this is known to improve the efficacy of tramadol in relieving pain. Despite the fact that tramadol is believed to be one of the most effective pain treatment in children, the several surveys in different European countries have demonstrated that postoperative pain in children has been a serious problem for a long period.
Kharasch (2003) supposed that besides the ethical imperative, sufficient pain relief may reduce the risk of subsequent morbidity and delay wound healing. Moreover, tramadol is a weak mu-opioid agonist and inhibits reuptake of noradrenaline and serotonin. In addition, the sufficient pain reduction or prevention is an important expectation of parents. Therefore, one of the most essential issues in perioperative care is an increase the efficiency of postoperative pain management in children. In order to get the effective and clear data, the Cochrane Central Register of Controlled Trials, Medline via PubMed as well as EMBASE via Ovid have been used.
Critique of Systematic Review
The Relevance of the Research Problem
For the last decade, a number of outpatient procedures in the children procedures have been rising rapidly (Segerdahl, 2008). The mail advantages in general and regional anesthetic techniques is an opportunity to perform a variety of procedures in daily surgery. In fact, unrelieved pain is the most significant reason for unanticipated hospital admission. Thus, an effectiveness of children surgery is truly connected with effective postoperative pain management. Tramadol is an effective treatment pf chronic and acute pain in children. Moreover, it has the most common reasons for unanticipated hospital admission. It is licensed for children treatment and widely used in the treatment of moderate and severe pain. Scott (2000) identified tramadol could not usually lead to incidence of side effects such as respiratory depression, nausea, vomiting, constipation, sedation in comparison with other opioids in both adults and children.
Children always experience pain after surgery, so that they tend to rely on parents or carer to provide the corresponding assistance and medication help to relieve the pain. The research of Schnabel, Reichl and et al (2015) demonstrates the findings of tramadol effectiveness and compare it with placebo for postoperative pain in children. Despite the fact that 1170 patients were assessed with the help of systematic research, the received data is not clear, because concealment of allocation processes and blinding of outcome assessors, which were poorly described. After the tests and researchers were completed, eight trials focused on the comparison of tramadol administration with placebo and five trials found the …
