Effects of Oral Alprazolam and Oral Tramadol on Anxiety and Analgesia in Patients Undergoing Breast Cancer Surgery

Objective: The aim of this study is to determine postoperative pain and anxiety condition of patients undergoing elective breast cancer surgery who recieved preoperative combination of Tramadol and Alprazolam. Methods: One hundred and twenty American Society of Anesthesiologists I-III patients undergoing elective breast surgery were enrolled clinically, randomized, prospectively in the study. Patients separated into Group 1 (Alprazolam 1 mg PO + Tramadol 100 mg PO), Group 2 (Alprazolam 1 mg PO + Tramadol 50 mg PO) and Group 3 (conventional premedication-control group). Alprazolam was given to the patients before the night of the operation. Tramadol was given to the patients before 60 min before the operation. All patients received standard general anesthesia. After extubation, st minute visual analogue scale (VAS) and richmond agitation sedation scale (RASS) values were recorded. In the recovery room, VAS and RASS values were recorded in 20th and 40th minutes and again in 24st hour. For statistical analysis of data, one-way Anova Test, Tukey HSD Test, Tamhane's T2 test were used. Results: In the postoperative period, levels of agitation caused by anxiety were lower in the patients who received preoperative Alprazolam (Group 1-2) than the patients who did not receive Alprazolam (Group 3) (p=0.007). RASS levels were significantly lower in the patients who received preoperative 100 mg Tramadol and 1 mg Alprazolam than the other groups. VAS levels were decreased in time in each group, but there was no difference in VAS levels between groups. Conclusion: We found that the preoperative combination of oral administered 100 mg Tramadol and 1 mg Alprazolam resulted in decreased anxiety in the postoperative period in patients undergoing elective breast cancer surgery.