A comparative study of epidural tramadol with epidural pentazocine for postoperativeanalgesia in patients undergoing lower abdominal surgeries

Abstract

INTRODUCTIONMan has always tried to tame and subdue the crippling force that pain had always been, and in the process devised various methods to overcome it, ranging from black magic to application of ice and hypnosis to opium. In most instances, acute painful disorders are correctly diagnosed and effectively treated, but in a significant number of cases, patients with severe or very severe post operative and post traumatic pain and severe visceral pain are not effectively relieved. Modern day anaesthesia is not just concerned with relieving pain during surgeries but also during post operative period. Post operative analgesia is gaining more weightage as it not only improves quality of life of the patient, but also results in faster recovery and reduces medical costs.Various modalities for post operative pain management are available today. Analgesia through the epidural route is one of the most preferred techniques for it. ABSTRACTBackground: To evaluate and compare the efficacy of epidurally administered Tramadol. Hydrochloride and Pentazocine Lactate in providing post operative pain relief for lower abdominal and lower limb surgeries. To compare the side effects between epidural tramadol and pentazocine. Design of the study was a prospective randomized study. Methods: The study population consisted of 100 patients aged between 18-65 years posted for various elective lower abdominal and lower limb surgeries requiring neuraxial anaesthesia at M.V.J. Medical College and Research Hospital, Hoskote, Bangalore. The study population was randomly divided into 2 groups with 50 patients in each sub group. Group T: Administered 50mg Tramadol, diluted to 10ml with Normal saline, epidurally (n = 50) Group P: Administered 0.3mg/kg Pentazocine, diluted to 10ml with Normal saline, epidurally (n = 50). Patient was monitored on various parameters including duration of action, hemodynamic variables, and side effects. Results: In group administered 50mg Tramadol epidurally, the mean time to onset of analgesia was 4.36±2.23 mins and the mean time to onset of analgesia in the group administered pentazocine was 4.84±2.24 mins, with a p value of 0.286, which is not considered significant. In tramadol group, the analgesic period averaged 7 hours 20 minutes, while the duration of analgesia in group P averaged 6 hours 43 minutes, with a p value of 0.475, which is not considered significant. It was also observed that 0.3mg/kg of pentazocine produced marginally higher incidence of bradycardia, dizziness, drowsiness. Conclusions: With these results, we conclude that epidural tramadol 50mg gives longer lasting and more profound analgesia with lesser side effects when compared to 0.3mg/kg of pentazocine.