Comparison of Tramadol Versus Bupivacaine as Local Anesthetic in Pain Control in Inguinal Hernia Surgery

Abstract

Objective: To compare the outcomes of local infiltration of tramadol versus bupivacaine for postoperative pain control and time to mobilize patients out of bed with less intravenous analgesia consumption in inguinal hernia surgery. Methodology: This randomized controlled trial was conducted at the Department of General Surgery, Pakistan Institute of Medical Sciences (PIMS), Islamabad September 2018 to August 2019. A total of 122 patients who were randomly allocated to either Group A (tramadol) or Group B (bupivacaine). Data on postoperative pain scores (VAS at 3, 6, 12, 24 hours), time to first analgesia, and time to mobilization were collected using a structured proforma and analyzed with SPSS version 26. Results: In the bupivacaine group, mean age was 34 ± 9 years; in the tramadol group, 31 ± 8 years. At 24 hours post-surgery, mean pain score was 5.2 ± 1 in bupivacaine and 2.7 ± 0.5 in tramadol. Tramadol showed significantly lower mean pain at 3rd, 6th, 12th, and 24th hours (p < 0.001). Time to first analgesia was 10 ± 7 hours in bupivacaine and 13.5 ± 5.6 hours in tramadol, indicating a statistically longer duration for tramadol (p < 0.05). Mobilization time was 9 ± 4 hours in bupivacaine and 6 ± 4.5 hours in tramadol, with tramadol showing significantly lower time to mobilize (p < 0.001). Conclusion: Tramadol local infiltration is effective in reducing pain, delaying analgesia need, and promoting earlier mobilization compared to bupivacaine. Consideration of tramadol at wound closure for inguinal hernia repair may enhance outcomes and patient satisfaction