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A Study to Compare the Effects of Low Dose Intrathecal Fentanyl and Low Dose Intrathecal Tramadol Combined with 0.5% Bupivacaine (Heavy) in Patients Undergoing Orthopaedic Surgeries

Hemnath Babu Kotla , P. Kalyan Chakravarthy1 , Hemnath Babu Kotla2

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Indian Journal of Anesthesia and Analgesia 6(4):p 1067-1075, July-August 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.2

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P. Kalyan Chakravarthy, Hemnath Babu Kotla. A Study to Compare the Effects of Low Dose Intrathecal Fentanyl and Low Dose Intrathecal Tramadol Combined with 0.5% Bupivacaine (Heavy) in Patients Undergoing Orthopaedic Surgeries. Indian J Anesth Analg. 2019;6(4):1067-1075.

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Abstract

Introduction: Relief of pain during operation and postoperative period is one of the main stay of balanced anaesthesia. Bupivacaine Hydrochloride is known for long procedures due to prolonged action. The addition of opioids has been opted as a method to reach these goals. Aims: To compare the intra-operative effects of a single low dose of intrathecal tramadol and fentanyl with hyperbaric bupivacaine hydrochloride. Materials and Methods: Fifty patients posted for various elective orthopedic procedures were studied in a randomized prospective double blinded manner. Patients will be randomly divided into two following groups. Group A: SAB with addition of 25 μg fentanyl to 3 ml of 0.5% Bupivacaine. Hydrochloride (hyperbaric), Group B: SAB with addition of 25 mg tramadol to 3 ml of 0.5% Bupivacaine Hydrochloride (hyperbaric). Results: During Intraoperative period no significant differences in BP, heart rate and respiratory rate were noted. There was no delay in time to full motor recovery in both the groups of patients. The mean duration of analgesia did not differ in both groups. Mean duration of analgesia in Group A was 565.4 minutes and in Group B was 551 min.Time for two segment regression did not differ in both the groups. The patients showed minimal side effects, like nausea, Vomiting, shivering and pruritis in both groups which was statistically insignificant. Conclusions: Both intrathecal tramadol and fentanyl act synergistically to potentiate bupivacaine induced sensory spinal block. Excellent surgical anaesthesia and an extended analgesia were observed in postoperative period with minimum side effects among both the groups.

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P. Kalyan Chakravarthy, Hemnath Babu Kotla. A Study to Compare the Effects of Low Dose Intrathecal Fentanyl and Low Dose Intrathecal Tramadol Combined with 0.5% Bupivacaine (Heavy) in Patients Undergoing Orthopaedic Surgeries. Indian J Anesth Analg. 2019;6(4):1067-1075.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6419.2

Keywords

Intrathecal tramadol; Bupivacaine; Orthopedic procedures.

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