31Jul 2017

A COMPARATIVE STUDY EFFECT OF INTRATHAECAL TRAMADOL (20MG) USE AS ADJUVANT WITH HYPERBARIC BUPIVACAINE (15MG) AND HYPERBARIC BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN INFRAUMBILICAL SURGERIES.

  • Assistant Professor ,Department of Anaesthesia,SMS Medical College,JaipurRajesthan India.
  • junior specialist, ,Department of Anaesthesia,SMS Medical College,JaipurRajesthan India.
  • Senior Professor, ,Department of Anaesthesia,SMS Medical College,JaipurRajesthan India.
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Background:Various adjuvants have been used with local anaestheticintrathecally for prolong postoperatively analgesia.Neuraxial opioids bind to intrathecal opioids receptors and produce analgesia.Tramadol is a centrally acting opioid,without common side effects of opioids.This prospective double blind randomized placebo controlled study aimed to evaluate duration of analgesia produced by intrathecal tramadol (20mg) used as adjuvant with bupivacaine0.5% (15mg)in infraumbilical surgeries. Material and method:In the study included total 56 patients either sex in age group 30-60 yrs,ASA 1&2 undergoing for infraumbilical surgeries randomly allocated in two groups.Group A(N-28)received 3 ml of hyperbaric bupivacaine 0.5% with 0.4ml of normal saline ,Group B (N-28) received 3 ml of hyperbaric bupivacaine 0.5% with tramadol (20mg) 0.4ml injected intrathecally.The onset and dutration of motor & sensory blockade ,VAS,sedationscore,intraophaemodynamicmonitoring,side effects ,duration of analgesia demand of first rescue of analgesia, were also compared in both groups at predetermined intervals. Results: There was no significant difference in demographical data , haemodynamic parameters and any side effects.There was significant difference in, onset of sensory blockade mean ? SD group A 3.39?0.562 min VS groupB 1.91?0.438min,osnset of motor blockade mean ? SD group A 4.67? 1.56 vsgroupB 2.4?0512, duration of sensory blockade mean ? SD group A 138?27.30 vs group B 2.54? 25.64,duration of motor blockade mean ? SD group A 118.78?23.44 vs group B 210.66?24.60,demand of first rescue of analgesia of mean ? SD groupA 180? 8.99 min vs group B 324.39?5.79 min (p value <0.001).VAS score was significantly low in group B than groupA. Conclusion: we conclude that use of tramadol as adjuvant intrathecal with hyperbaric bupivacaine early the onset of sensory and motor blockade and prolonged of duration of analgesia by prolonging duration of requirement of first rescue of analgesia without increasing incidence of side effects in infraumbilical surgeries.

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[Sunita Meena, Rakesh Agarwal and Ramesh Chandra Sunar. (2017); A COMPARATIVE STUDY EFFECT OF INTRATHAECAL TRAMADOL (20MG) USE AS ADJUVANT WITH HYPERBARIC BUPIVACAINE (15MG) AND HYPERBARIC BUPIVACAINE FOR POSTOPERATIVE ANALGESIA IN INFRAUMBILICAL SURGERIES. Int. J. of Adv. Res. 5 (Jul). 2671-2675] (ISSN 2320-5407). www.journalijar.com

Dr Sunita Meena
Assistant Professor ,Department of Anaesthesia,SMS Medical College,Jaipur Rajesthan India

DOI:

Article DOI: 10.21474/IJAR01/5009      
DOI URL: https://dx.doi.org/10.21474/IJAR01/5009

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