Display options
Share it on

Anesth Essays Res. 2015 Sep-Dec;9(3):369-73. doi: 10.4103/0259-1162.161805.

Postoperative analgesic efficacy of epidural tramadol as adjutant to ropivacaine in adult upper abdominal surgeries.

Anesthesia, essays and researches

Anil P Singh, Dharmraj Singh, Yashpal Singh, Gaurav Jain

Affiliations

  1. Department of Anaesthesiology and Intensive Care, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

PMID: 26712976 PMCID: PMC4683493 DOI: 10.4103/0259-1162.161805

Abstract

BACKGROUND: Postoperative pain control after major abdominal surgery is the prime concern of anesthesiologist. Among various methodologies, epidural analgesia is the most preferred technique because of the excellent quality of analgesia with minimum side-effects.

AIM: The present study was designated to compare postoperative analgesic efficacy and safety of epidural tramadol as adjuvant to ropivacaine (0.2%) in adult upper abdominal surgery.

SETTINGS AND DESIGN: Prospective, randomized-controlled, double-blinded trial.

MATERIALS AND METHODS: Ninety patients planned for upper abdominal surgery under general anesthesia were randomized into three equal groups to receive epidural drug via epidural catheter at start of incisional wound closure: Group R to receive ropivacaine (0.2%); Group RT1 to receive tramadol 1 mg/kg with ropivacaine (0.2%); and RT2 to receive tramadol 2 mg/kg with ropivacaine (0.2%). Duration and quality of analgesia (visual analog scale [VAS] score), hemodynamic parameters, and adverse event were recorded and statistically analyzed.

STATISTICAL ANALYSIS: One-way analysis of variance test, Fisher's exact test/Chi-square test, whichever appropriate. A P < 0.05 was considered significant.

RESULTS: Mean duration of analgesia after epidural bolus drug was significantly higher in Group RT2 (584 ± 58 min) when compared with RT1 (394 ± 46 min) or R Group (283 ± 35 min). VAS score was always lower in RT2 Group in comparison to other group during the study. Hemodynamic parameter remained stable in all three groups.

CONCLUSION: We conclude that tramadol 2 mg/kg with ropivacaine (0.2%) provides more effective and longer-duration analgesia than tramadol 1 mg/kg with ropivacaine (0.2%).

Keywords: Epidural analgesia; postoperative pain; ropivacaine; tramadol

References

  1. Drugs. 2000 Nov;60(5):1065-93 - PubMed
  2. Anaesthesia. 1993 Apr;48(4):328-31 - PubMed
  3. Reg Anesth Pain Med. 1998 Sep-Oct;23(5):433-8 - PubMed
  4. Acta Anaesthesiol Scand. 2001 Jul;45(6):786-9 - PubMed
  5. Anesth Analg. 1996 Jul;83(1):87-91 - PubMed
  6. J Pharmacol Exp Ther. 1993 Oct;267(1):331-40 - PubMed
  7. Paediatr Anaesth. 2001 May;11(3):323-6 - PubMed
  8. Eur J Anaesthesiol. 1995 May;12(3):265-71 - PubMed
  9. Can J Anaesth. 1999 Aug;46(8):731-5 - PubMed
  10. Ma Zui Xue Za Zhi. 1991 Sep;29(3):648-52 - PubMed
  11. Anaesthesist. 1994 Jan;43(1):55-72 - PubMed
  12. Expert Rev Neurother. 2004 Sep;4(5):781-91 - PubMed
  13. Anesth Analg. 1997 Dec;85(6):1322-30 - PubMed
  14. Eur J Pharmacol. 1986 Jan 14;120(1):75-80 - PubMed
  15. Anaesthesia. 1992 Apr;47(4):291-6 - PubMed
  16. Br J Anaesth. 1983 Feb;55(2):163-7 - PubMed
  17. BMJ. 1990 Jun 30;300(6741):1687-90 - PubMed
  18. Br J Anaesth. 2006 Sep;97(3):385-8 - PubMed
  19. Can J Anaesth. 1993 Apr;40(4):308-13 - PubMed

Publication Types