Comparative study of intrathecal tramadol and fentanyl as adjuvants in lower abdominal surgeries

Abstract

Spinal anesthesia is preferred choice of anesthesia in lower abdominal surgeries for a long time. However, the problem with this is limited duration of action, so for long duration surgeries alternatives are required.
 The aim: to compare the intra-operative effects of a low dose of intrathecal tramadol and intrathecal fentanyl with hyperbaric bupivacaine hydrochloride.
 Materials and methods: prospective randomized control study for a duration of study is one year. 50 patients, aged 18 years to 60 years, belonging to ASA physical status I and II, posted for elective lower abdominal surgeries under spinal anaesthesia were chosen.
 These patients were divided into two groups: group BT- this group of patients received 2.5 mL volume of 0.5 % hyperbaric bupivacaine with 25 mg of tramadol intrathecally. Group BF- this group of patients received 2.5 mL volume of 0.5 % hyperbaric bupivacaine with 25 μg of fentanyl intrathecally.
 Results: demographic parameters in both the groups are not statistically significant. The association between the differences in duration of surgeries of both the study groups is not statistically. The association between the differences in mean time of onset of sensory block and motor block of both the study groups was comparable with p>0.05
 The duration of sensory block (analgesia) and duration of motor block difference between the two means was statistically significant with p<0.0000001. The difference between the mean VAS score at 3 hours and at 20 hours was statistically significant with p<0.05. Among the study BT group, 52 % needed 2 analgesics and 48 % needed 3 doses of analgesics. Among BF group, 6 % needed only one dose of analgesics and 44 % needed 2 doses of analgesics. The difference between the two was statistically significant with p<0.000002. The association between the hemodynamic variables between both the groups at the end of procedure was statistically significant with p<0.05.
 Conclusions: Intrathecal fentanyl and tramadol produced a similar onset of sensory and motor blocks. Fentanyl provided better duration and quality of postoperative analgesia compared to tramadol