A Comparative Study of Intrathecal versus Epidural Tramadol for Post Operative Analgesia

What is it about?

A Comparative Study of Intrathecal versus Epidural Tramadol for Post Operative Analgesia

Featured Image

Why is it important?

Background: Pain is an integral part of all surgery and is the biggest cause of apprehension amongst patients. This apprehensive behavior creates a feeling of dissatisfaction with the pain relief methods used conventionally. Easy availability, ease administration and economical makes a method of analgesia successful (Lehmann et al.). Inj. Tramadol is a synthetic agonist opioid analgesic without any preference for any particular type of opioid receptor. Its presence in the central neuraxial system mediates the nociceptive action when given either intra thecally or epidurally. Aim: The present study was designated to compare postoperative analgesic efficacy and safety of epidural tramadol vs. intrathecal tramadol along with its physiological side effects. Study Design: Prospective, randomized-controlled, blinded trial. Methodology: 60 patients of either sex, ASA status I or II and posted for abdominal surgeries, gynecological surgeries, orthopedic surgeries were studied in two groups to receive either Inj. Tramadol intra thecally (Group II) along with spinal anesthesia or Epidurally (Group I) along with single shot epidural anesthesia. Duration and quality of analgesia (visual analog scale [VAS] scores), hemodynamic parameters, and adverse event were recorded and statistically analyzed using Chi square test and a p value of <0.05 was considered significant. Results: Mean duration of analgesia after epidural bolus of opioid tramadol was 9.86 ± 2.19 hours as compared to intrathecal tramadol which was significantly higher 14.23 ± 1.76. VAS score was always lower in Group I in comparison to other group during the study at various intervals. Hemodynamic parameter remained stable in both the groups. Conclusion: We conclude that tramadol 0.5 mg/kg with bupivacaine 0.5% intrathecally provides more effective and longer-duration analgesia than tramadol 1 mg/kg with bupivacaine 0.05% when given epidurally.

Perspectives