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Indian Journal of Anesthesia and Analgesia

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Comparative Study of Postoperative Analgesia with Epidural Bupivacaine Versus Epidural Bupivacaine and Tramadol

Vinayak N. Panchgar, Assistant Professor, Dept. of Anaesthesiology, Gadag Institute of Medical Sciences, Gadag, Karnataka 582103, India. , Shivaraddi Bhandi1 , Vinayak N. Panchgar2 , Harish Nadagoudar3

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Indian Journal of Anesthesia and Analgesia 5(7):p 1192-1198, July 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5718.16

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Abstract

Background: Pain is constant and predominant complaint of individual following, most surgical intervention. Epidural narcotics have been in large number of studies for treatment of postoperative epidural n arcotic like morphine has adverse effects like respiratory depression, drug dependence and cannot be used in elderly. Hence this clinical study of epidural bupivacaine and epidural bupivacaine plus tramadol is undertaken to evaluate the feasibility has effective analgesia for postoperative pain relief.

Objectives: To compare epidural bupivacaine and epidural bupivacaine plus tramadol for postoperative analgesia focusing on onset of analgesia, duration of analgesia, cardiorespiratory effects like pulse rate, blood pressure and respiratory rate, sedation.

Methods: 100 patients belonging to ASA physical status I & II scheduled for abdominal, pelvic, lower limb surgeries, were randomly selected for study are divided into two groups of 50 patients each. Group B patient received 10 ml of 0.125% bupivacaine epidurally. Group B+T patient received 10ml of 0.125% bupivacaine+ 50 mg tramadol epidurally during their postoperative period, when they complain pain for the first time onset and duration of analgesia, haemodynamic parameters and adverse effects if any were studied. 

Results: There was no significant difference be tween two groups in mean time of onset of analgesia, 14.40±0.85 minutes with group B and 14.62±0.69 minutes with group B+T (p-value 0.14), total duration of analgesia in group B was 231.6±9.1 minutes and in group B+T was 350.60±15.9 minutes which was significant (p-value <0.05). Quality of postoperative analgesia, haemodynamic parameters and side effects were comparable between both groups.

Conclusion: Epidural bupivacaine (10ml of 0.125%) plus 50 mg tramadol combination not only provides an adequate, rapid, excellent postoperative analgesia, but also has significant longer duration of analgesia compared to bupivacaine alone.


 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5718.16

Keywords

Bupivacaine; Tramadol; Epidural; Postoperative Analgesia.

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