ISSN No. 2079-8547 (Recognized by PMDC)
COMPUTED TOMOGRAPHIC SCAN FINDINGS IN HEAD INJURY PATIENTS
Abstract
Objective: To asses the efficacy of addition of tramadol to bupivacaine in prolonging the duration of post operative
analgesia in spinal anaesthesia.
Study Design: Double blinded randomized controlled clinical trial.
Methodology: One hundred ASA I–II patients listed for urological surgery were randomized to two groups of 50 patients
each. Group A (n=50) received 2 ml of 0.75% hyperbaric bupivacaine (15 mg) with 0.2 ml of normal saline and Group
B (n=50) received 2 ml 0.75% hyperbaric bupivacaine and 0.2 ml (20 mg) tramadol by intrathecal route at L3-4 inter
space. Standard monitoring of the vital parameters was done during the study period. Postoperatively, the pain score
was recorded by using visual analog pain scale (VAS) between 0 and 10 (0 = no pain, 10 = most severe pain). The
patient was medicated and the time was recorded. Duration of analgesia or pain free period was estimated from the
time of completion of spinal injection to administration of rescue analgesic administered on demand or when the VAS
score was greater than 4. Diclofenac 75 mg was given intramuscularly as rescue analgesia.
Results: The duration of analgesia was 216 ± 12.18 min in Group A; whereas, in Group B, it was 392 ± 11.78 min,
which was found to be extremely statistically significant. P-value less than 0.0001.
Conclusion: In conclusion, this study has demonstrated that tramadol 20 mg when added to 0.75% hyperbaric bupivacaine
intrathecally, significantly prolongs postoperative analgesia after major urological surgeries.
Key Words: Spinal anaesthesia, bupivacaine, intrathecal, post operative analgesia, tramadol