Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after lower limb Orthopaedic surgeries

Dr. Akil Hussain; Dr. Shaheer Ahmed Siddiqui; Dr. Meenaxi Sharma; Dr. Gaurav Madhesiya

Volume : VI, Issue : III, March - 2016

Intrathecal tramadol added to bupivacaine as spinal anesthetic increases analgesic effect of the spinal blockade after lower limb Orthopaedic surgeries

Dr. Akil Hussain, Dr. Shaheer Ahmed Siddiqui, Dr. Meenaxi Sharma, Dr. Gaurav Madhesiya

Abstract :

The analgesic effect of the centrally acting opioid, tramadol, is well–known. It has been shown in clinical studies that using tramadol epidurally can provide longer duration of analgesia, without the common side effects of opioids. The study was undertaken to evaluate the duration of analgesia and/or pain free period produced by intrathecal tramadol added to bupivacaine in patients undergoing lower limb orthopaedic surgery in a randomized double blind placebo controlled protocol. 100 patients ASA I & II scheduled for various lower limb orthopaedic surgeries were randomly allocated to two equal groups. Group A (n=50) received 3 ml of 0.5% hyperbaric bupivacaine (15 mg) with 0.2 ml of normal saline and Group B (n=50) received 3 ml 0.5% hyperbaric bupivacaine and 0.2 ml (20 mg) tramadol by intrathecal route at L3–4 inter space. Standard monitoring of the vital parameters was done during the study period. Levels 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 the surgical procedure. Assessment of pain was done using Visual Analogue Scale (VAS). The study was concluded when the VAS was more than 40 mm, postoperatively. The patient was medicated and the time was recorded. Duration of analgesia or pain free period was estimated from the time of completion of spinal injection to administration of rescue analgesic or when the VAS score was greater than 40 mm. In Group B patients, the VAS score was significantly lower, as compared to Group A patients. The duration of analgesia was 210 ± 10.12 min in Group A; whereas, in Group B, it was 380 ± 11.82 min, which was found to be significant.