Efficacy of Ketamine Hcl and Tramadol Hcl by epidural route for lower abdominal surgeries

ABSTRACT

Background: Pain pathway has profound implications for management of acute pain and provoked interest in the use of pre-emptive analgesia and new methods of postoperative pain management with new agents like opioid and non-opioid drugs either independently or in combination. The objective of the study was to study efficacy of Ketamine Hcl and Tramadol Hcl (preservative free) by epidural route for lower abdominal surgeries.Methods: This study has been conducted on hundred patients in the age group of 20 to 50 years. These patients have undergone various lower abdominal surgeries, gynecological and surgical procedures. Failed epidurals, catheter kinking, catheter migration and dural puncture cases are excluded from the study. The patients were divided into two groups namely Group-A and Group-B, with 50 patients in each group.Results: Both groups were similar in terms of age, sex and weight. In Group-A patients who received 30 mg of Ketamine, the mean time of onset of analgesia being 17.01+2.65 minutes compared to 12.18+2.28 minutes in Group -B patients who received 100 mg of tramadol, In Group-A the mean time of duration of analgesia is 6.75+0.46 hours compared to 9.36+0.84 hours in Group-B. Nausea and vomiting (24% vs. 2%), urinary retention (4% vs. 2%) was more in group B compared to group A patients. Backache was equal in both the group patients (6% vs. 6%). Pain on injection more in group A patients i.e. 8% compared to only 2% in patients who belonged to group B.Conclusions: Epidural tramadol is superior to epidural ketamine for postoperative pain relief.