Objective: To assess the effect of intra–thecal tramadol added to bupivacaine to prolong the duration of analgesia in subarachnoid block for lower limb orthopaedic surgeries.

Material and Methods: Patients were selected by non–probability consecutive sampling. One hundred and fifty patients from American Society of Anaesthesiologists (ASA) I, II and III category fulfilling inclusion criteria undergoing various lower limb orthopaedic surgeries were divided into two groups by lottery system. Group tramadol bupivacaine (TB) received 25mg (1 ml) of tramadol plus 2ml (10mg) of 0.5% bupivacaine while group bupivacaine alone (SB) received 1 ml normal saline plus 2ml (10mg) of 0.5% bupivacaine. Time to first analgesia request was noted as a measure of duration of analgesia. Time of onset of sensory block level and peak sensory block level and time to reach the peak sensory block level were also noted. Quality of anaesthesia was compared among two groups. Data were analyzed by using SPSS version 22.

Results: Four patients were excluded from the study. The duration of anaesthesia was effectively prolonged in group TB 181.56 ± 12.42 mins as compared to group SB 120.93 ± 15.54 mins. VAS score was significantly lower in group TB. Higher peak sensory block levels (T6) were achieved in group TB as compared to group SB. However time to reach the peak sensory block levels were significantly longer in group TB. (4.5 ± 0.47mins vs 3.09 ± 0.54 mins).

Conclusion: This study showed that intra–thecal tramadol (25mg) can safely be used along with bupivacaine in subarachnoid blockade to prolong the duration of analgesia and improve the quality of anaesthesia as well.