Original Articles: 2016 Vol: 8 Issue: 9
Evaluation of Postoperative Analgesic Effects of Intrathecal Tramadol with Bupivacaine and Bupivacaine Alone in Patients Undergoing Lower Abdominal Surgery: A Comparative Study
Abstract
Effective pain control is essential for optimum care of patients in the postoperative period. Epidural and intrathecal administration of drugs have been used increasingly for relief of postoperative pain. Tramadol is a centrally acting analgesic that has minimal respiratory depressant effects compared to other opioids like morphine. This study was conducted to evaluate safety and efficacy of the intrathecal tramadol and to determine the postoperative analgesia. Sixty ASA I and II patients were randomly assigned to two groups. Group B (n=30) received 3ml of 0.5% heavy bupivacaine with 0.5ml of normal saline and group BT (n=30) received 3ml of heavy bupivacaine with 0.5ml(25mg) of preservative free tramadol by intrathecal route at L3-L4 intervertebral space. Patient’s vital parameters, level of sensory block and sedation score were recorded every two minutes for the first 20 minutes and then every ten minutes for the rest of surgical procedure. Assessment of pain was done using visual analogue scale (VAS= 0-100mm). Duration of analgesia was estimated from the time of completion of spinal injection to administration of rescue analgesic. In group BT patients the VAS score was significantly lower as compared to group B patients. The mean duration of analgesia was 393.33±123.21 minutes in group BT, whereas in group B it was 167.47±12.46 minutes, which was found to be statistically significant. We hereby conclude that 25mg tramadol with hyperbaric bupivacaine intrathecally provides a better postoperative analgesia in lower abdominal surgeries.