Effects of epidura[ Bupivacaine with tramadol on the duration of epidural anaesthiesia and postoperative analgesia in patients undergoing lower limb orthopedic surgery.

Abstract

This clinical trial study was conducted in Assiut University Hospital, orn 45 patients undergoing lower limb orthopedic surgery. All patients were of ASAphysical state I and IT to evaluate the effect of epidural tramadol on bupivacaine anaesthesia and postoperative analgesia. Patients were randomly allocated to 3 groups, 15 patients in each one. Group l (control) received 20m!bupivacaine 0.5% +!Oml 0.9%saline. Group 2 received 20m!bupivacaine 0.5% +I OOmg tramadol (2m!)+ 8ml saline. Group 3 received 20m!bupivacaine 0.5% +200mg tramadol (4ml)+ 6ml saline. All subsequent doses of tramadol postoperatively were given at the patient's request according to the severity of pain till pain scores were nearly fair in a doS!e of I OOmg each injection. The following data Were measured and recorded:-

1- Operative time.

2- Haemodynamic data: - heart rate by ECG lead2 and v5and llllOn- invasive blood pressure (systolic, diastolic and mean) before drug administrallion, intraoperative and postoperative up to 24 hours.

3- Respiratory rate: - basal reading was taken before drug administration then intra- and post- operatively up to 24 hours. 4- . 02 saturation was monitored throughout the operative procedure.

5- Assessment of sensory blockade by pinprick to measure tlime required to reach sensory block at dorsal 12, maximum level, and time of regression below the inguinal ligament.

6- Assessment of motor blockade by Bromage scale.