Title: A Comparative study of epidural Fentanyl with Bupivacaine & epidural Tramadol with Bupivacaine for post operative pain relief after lower abdominal Surgery
Authors: Dr Sudhir Patil, Dr Abhijeet Birnale, Dr Suresh Patil, Dr Pradeep Patil
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.205
Abstract
Background: Postoperative pain control is crucial part of management of patients undergoing major abdominal surgeries. In most of the major hospital there is a gradual shift from on-demand opioid injections to epidural analgesia which is found to have excellent quality of analgesia and minimum side effects. Fentanyl, a μ opioid agonist, when used alone has short onset of action about 5 minutes and lasting for about 3-4 hours. Tramadol hydrochloride is a weak opioid having analgesic properties. Both of these drugs fentanyl and Tramadol are used widely for epidural analgesia in patients undergoing various types of surgeries. Addition of Bupivacaine prolongs analgesic effect of Fentanyl as well as Tramadol.
Aims And Objectives: To compare the efficacy of epidural Fentanyl with Bupivacaine and epidural Tramadol with Bupivacaine for postoperative analgesia in patients undergoing lower abdominal surgeries.
Materials and Methods: Sixty patients were included in our comparative study and they were randomly divided into two groups, Group A and B. Group A received 50 mcg Fentanyl + 8ml 0.125% Bupivacaine as a bolus dose and patients in group B received 50 mg Tramadol+ 8ml 0.125% Bupivacaine as a bolus dose. The parameters like demographic characteristics, postoperative pain and postoperative analgesia were compared in both the groups.
Results: Mean duration of analgesia after epidural bolus drug was significantly higher in Group A when compared with group B. Postoperative VAS score was found to be lower in Group A as compared to group B. Hemodynamic parameter remained stable in both the groups.
Conclusion: Epidural fentanyl along with Bupivacaine has better and prolonged postoperative analgesic effect and fewer complications as compared to Tramadol with Bupivacaine in patients undergoing lower abdominal surgeries.
Keywords: Postoperative analgesia, Tramadol, Fentanyl, Complications.
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