Comparative study of ropivacaine with tramadol and ropivacaine with midazolam for post-operative epidural analgesia

Abstract

Epidural analgesia is the most commonly used method for surgical anesthesia, obstetric analgesia, post-operative pain control, and chronic pain management. These epidurals are used either as a single-shot technique or with the catheter that allows intermittent boluses or continuous infusion, or both. All of these variables are controlled by choice of drug concentration, dosage, and level of injections. To compare the onset and duration of sensory block, motor block, and post-operative analgesia duration using Ropivacaine with Tramadol and Ropivacaine with Midazolam in the Epidural technique. In this prospective, non-randomized, comparative study, the total of 160 patients who underwent surgeries below the umbilicus did under epidural technique at Govt. Kilpauk Medical college hospital a Govt. Royapettah hospital, Chennai, was screened. Patients were divided into two groups. Patients in Group R received an epidural injection of 0.5% Ropivacaine (30ml) with Tramadol 2 mg/kg, whereas patients in Group L received an epidural injection of 0.5% ropivacaine (30ml) with Midazolam (50mg/kg). On studying the comparison of the onset of sensory, motor blockade, and duration of the sensory-motor blockade in the two groups, the onset of sensory blockade, motor blockade, and duration of motor blockade was more among ropivacaine with midazolam group. In comparison, the duration of sensory blockade was more among ropivacaine with tramadol group. A statistically significant difference in onset of sensory, motor blockade, and duration of sensory blockade across the group was found (p<0.005). Tramadol or Midazolam's addition to caudal epidural block with ropivacaine showed significant prolongation of post-operative analgesia compared to ropivacaine alone. The mean duration of analgesia was more among ropivacaine with the Tramadol group.