02Mar 2018

A DOSE FINDING STUDY TO EVALUATE THE DURATION OF POSTOPERATIVE ANALGESIA IN UROLOGICAL SURGICAL PATIENTS, USING DIFFERENT DOSES OF EPIDURAL TRAMADOL.

  • Lecturer, Department of Cardiothoracic Anaesthesia, Super speciality Hospital, GMC, Jammu.
  • Consultant Anaesthesia, Health and Medical Education Deptt. J&K.
  • Professor, Department of Anaesthesia and Critical care, Sher-i-Kashmir Institute of Medical Sciences, Srinagar.
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Introduction: Pain control is essential for optimal care of surgical patients. Intravenous drugs need close monitoring and morphine sulphate has serious side effects. Tramadol hydrochloride has been used both intravenously and epidurally and results have been found to be comparable with morphine. Method: Sixty ASA I and II patients scheduled for elective urological surgery were divided into three equal groups in a randomized, double blinded fashion. Group I, II, III received 1, 2 and 3 mg/kg body weight epidural Tramadol respectively. Onset time, duration and side effects of analgesia were studied in all the groups. Result: Duration of pain relief in group I, II, III was 6, 10, 20 hrs respectively which was statistically significant. Incidence of post operative nausea and vomiting was significant in group III compared to other groups. Conclusion: 2 mg/kg body weight epidural Tramadol is optimum dose for postoperative analgesia without significant side effects and in dose 3 mg/kg body weight, can be used with appropriate anti-emetics to reduce the incidence of nausea and vomiting.

  1. Measurement and control of postoperative pain. Ann R Coll Engl 1979;6:419.
  2. Current status of postoperative pain therapy. P169. In Yokota T, Dubner Reds: Current Experta Medica, Amsterdam 1983.
  3. Merskey H, Albe Fessard DG, Bonica. Pain term. A list with definitions and notes on usage. Pain 1979;6:249.
  4. Graves D, Foster A, Batenhorst RL, Bennett RL. Patient controlled analgesia. Ann Intern Med 1983;99:360.
  5. Graves DA, Arrigo JM, Foster TS, et al. Relationship between plasma morphine concentrations and pharmacological effects. Clin Pharm 1985;4:41.
  6. Cousins MJ, Cherry DA and Gourlay GK. Acute and chronic pain:Use of spinal opioids. In Cousins MJ and Bridenbough PO. Neural blockade in Clinical Anaesthesia and Management of Pain 2nd ed. pp 993-996, Philadelphia JB Lippincott 1987.
  7. Guinard JP, Mavrocordatos P, Cuttat JF and Carpenter R. Arandomized comparison of intravenous versus lumbar and thoracic epidural fentanyl for analgesia after thoracotomy. Anesthesiology 1992;77:1108.
  8. Gustafsson LL, Schild B and Jocobsen K. Adverse effects of extradural and intrathecal opiates: Report of a nation wide survey in Sweden. Br J Anaesth 1982;54:479.
  9. Demiraran YU, Kocaman B, Akman RY. A comparison of the postoperative analgesic efficacy of single dose epidural tramadol versus morphine in children. BJA 2005;95:510-513.
  10. Baraka A, Jabbour S, Ghabash M et al. A comparison of epidural tramedol and epidural morphine for postoperative analgesia. Can J Anaesth 1993;40:308-313.
  11. Price DD, Bush FM, Long S, Harkwins SW. A comparison of pain measurement characteristics of mechanical visual analogue and simple numerical rating scales. Pain 1994;56:217-226.
  12. Narain Harisinghain, M. Venogopal et al. Rectus sheath block for postoperative pain relief. Ind. J Anaesthesia 1984;32(3):225.
  13. Bonica JJ. Managaement of pain. Phaladelphia Lea and Febiger 1953.
  14. Bromage PR, Comporesi E, Chestnut D. Epidural narcotics for postoperative analgesia. Anesth Analg 1980;59:473.
  15. Nimo WS, et al. Pain relief after surgery. Anaessthesia and Intensive Care 1987;15:68-71.
  16. Fu YP, Chan KH, Lee TK et al. Epidural tramadol for postoperative pain relief. Ma Tsui Hsueh Tsa Chi 1991;29(3):648-652.
  17. AK Pan, Mukherjee P, Rudre A. Role of tramadol hydrochloride on postoperative pain relief in caesarean section delivery. J Indian Med Assoc 1997;95(4): 105-106.
  18. DP Prosser, A Davis, PD Booker et al. Caudal tramadol for postoperative analgesia in paediatric hypospadias surgery. BJA 1997;79:293-296.
  19. Naquib M, Saraj M, Ahia M, Samarkandi A, Seet M, Jardani R.Perioperative antinoceptive effects of tramadol for postoperative pain relief. Anaesthesia 1993;48:328-31.
  20. Chruborik J. Buzina M et al. Intravenous stramadol for postoperative pain-comparision of intermittent close regimen with or without maintenance infusion. Eur J Anaesthesia 1991;9:23-28.
  21. Vikers MD, O?Flaherty D, Szekely SM et al. Tramadol: pain relief by an opioid without depression of respiration. Anaesthesia 1992;47:291-296.

[Rasmeet Kour, Qumar- un-Nisa and Abdul Qayoom Dar. (2018); A DOSE FINDING STUDY TO EVALUATE THE DURATION OF POSTOPERATIVE ANALGESIA IN UROLOGICAL SURGICAL PATIENTS, USING DIFFERENT DOSES OF EPIDURAL TRAMADOL. Int. J. of Adv. Res. 6 (Mar). 215-219] (ISSN 2320-5407). www.journalijar.com

Dr. Rasmeet kour
Lecturer, Department of Cardiothoracic Anaesthesia, Super speciality Hospital, GMC ,Jammu.

DOI:

Article DOI: 10.21474/IJAR01/666910.21474/IJAR01/6669      
DOI URL: https://dx.doi.org/10.21474/IJAR01/666910.21474/IJAR01/6669

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