ISSN: 2577-4301
Authors: Shilpashri AM*, Lakshmi DD, Priya R and Akash JS
Background: The treatment of acute postoperative pain is important for modern health services. Analgesia through epidural route appears to have a brighter prospect these days. Local anesthetics like bupivacaine and ropivacaine given in epidural space have helped in successful postoperative pain management. Addition of opioids to local anesthetics has a synergistic action on analgesia. Objective: To compare analgesic efficacy of Bupivacaine and Ropivacaine in combination with Tramadol for postoperative epidural analgesia in terms of the quality of analgesia, its duration of action and side effects involved. Materials and methods: 50 patients of age 18-60 years with American Society of Anesthesiologists grade I & II, undergoing elective abdominal and lower limb surgeries were randomly allotted to each of the 2 groups. Group BT received 0.25% bupivacaine + tramadol (1 mg/kg) and group RT received 0.25% ropivacaine + tramadol (1 mg/kg) epidurally. Patients were monitored for onset, duration and quality of analgesia, cardiorespiratory stability and for any side effects or motor blockade. Results: The mean time of onset of analgesia and quality of analgesia were comparable between the two groups. The duration of action in group RT (417.20 ± 42.52 mins) was found significantly prolonged than group BT (356.00 ± 49.03 mins) with p < 0.001. Significant fall in blood pressures was seen in group BT when compared with group RT. 4 patients in group BT had motor blockade while none in group RT. There were no significant side effects in both the groups.Conclusion: In our study, we found that Ropivacaine with Tramadol as epidural postoperative analgesia provided equal and effective analgesia when compared to Bupivacaine with Tramadol, but for longer duration and with minimal cardiovascular depression and no motor blockade.
Keywords: Bupivacaine; Tramadol; Postoperative analgesia; Epidural analgesia
