Randomized Trial of Quantitative Correlation of Thoracic Epidural Tramadol with Postoperative Analgesia in Patients Undergoing Thoracotomy

ABSTRACT

Early postoperative pain in patients undergoing thoracotomy may be intense, and can delay the rehabilitationand mobilization unless appropriately treated. General, Epidural and combination of these have separaterisks and benefits which vary according to patient's comorbidity and medications. Intravenous drugs foranalgesia like morphine sulphate need close monitoring as they cause respiratory depression.. Tramadolhydrochloride has been used both intravenously and epidurally and results have been found to be comparablewith morphine. Sixty three ASA I and II patients scheduled for elective thoracotomy were divided intothree equal groups in a randomized, double blinded fashion. Group I, II, III received 1, 2 and 3 mg/kg bodyweight Thoracic epidural Tramadol respectively. Onset time, duration and side effects of analgesia werestudied in all the groups.Duration of pain relief in group I, II, III was 6, 10, 20 hrs respectively which wasstatistically significant. Incidence of post operative nausea and vomiting was significant in group III comparedto other groups. It is concluded that 2 mg/kg body weight thoracic epidural Tramadol is optimum dose forpostoperative analgesia without significant side effects and in dose 3 mg/kg body weight, can be used withappropriate anti-emetics to reduce the incidence of nausea and vomiting.