comparative study of duration of analgesia with epidural bupivacaine & bupivacaine with tramadol in lower limb and lower abdominal surgeries

Background: The administration of local anaesthetic opioid mixtures neuraxially (particularly epidurally) is excellent for post-operative pain following abdominal, pelvic or orthopaedic procedures on lower extremities. The rational for this relatively new technique in post-operative pain management is a better quality of analgesia that can be achieved by systemically administered analgesics, a lower incidence of side-effects, improved surgical outcome and high levels of patient satisfaction. Therefore, this study was taken up to evaluate the efficacy of epidural opioids in the management of post-operative pain. Methods: A total of 80 patients group A 40& group B 40 ,of age 20-70yrs and ASAI &II, were selected for the study who were admitted for lower abdominal and lower limb surgeries . Group A was given epidural bupivacaine 0.5% & group B was given epidural bupivacaine 0.5% with tramadol 50mg. The onset & duration of analgesia, effects on the hemodynamics and side effects were evaluated and compared between two groups. Pain was evaluated on VAS scale and end point of study was when rescue analgesic was given on demand. Result- In this study, we used 1 ml (50 mg) tramadol with 0.5% bupivacaine (15-20 ml) through epidural route in patients for short surgical procedures in lower extremity & lower abdomen, it was found that mean duration of analgesia was significantly longer than the patients who received 15-20 ml 0.5% bupivacaine only through the same route. Key words- neuraxial, epidural, tramadol, bupivacain