Effectiveness of Tramadol with Bupivacaine Versus Bupivacaine Alone on Postoperative Analgesia at Wolaita Sodo, Southern Ethiopia: Observational Cohort Study

Abstract

Background: Postoperative pain can cause immediate and extended consequences of poor outcome and result in extended hospitalization. It also progresses to chronic pain, if not intervening early. Wound site infiltration with a mixture of tramadol and bupivacaine is inexpensive, easy, and useful means of providing desirable analgesia for postoperative pain relief. The purpose of the study was to compare the analgesic effectiveness of bupivacaine with the tramadol combination and bupivacaine alone as part of postoperative pain management.Method: A prospective cohort study was employed on 120 patients who underwent elective lower abdominal surgery under general or spinal anesthesia with a systematic random sampling technique. Pain severity was measured by using a numerical rating scale, and the employment of additional analgesics was recorded for 24 hours between the two groups. The Mann-Whitney test and chi-square test were used to compare the median pain score and total analgesia consumption. Kaplan-Meier survival analysis was used to compare the time to first analgesic request between the two groups. Statistical significance was stated at a p value < 0.05 with a power of 95%.Result: Postoperatively, the median (interquartile range) of pain severity score was 1.0 (0-5) in the BT group compared with 5 (3-6) in the BA group. And, time to first analgesic request with the BT group, was 18 hours, 95% CI: (14.53- 21.47), had longer time compared to patients in the BA group was 6 hours, 95% CI:(4.48 - 7.71).Conclusion and Recommendation: Local wound infiltration with a mixture of Bupivacaine and Tramadol decreases the postoperative pain score, total analgesia consumption and has prolonged time to first analgesia request. Therefore, we recommend using a mixture of 0.25% bupivacaine with tramadol is effective for postoperative analgesia.