ATTENTION

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INFORMATION:

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EFFECT OF INTRATHECAL TRAMADOL COMBINATION WITH BUPIVACAINE FOR POST OPERATIVE PAIN RELIEF AFTER LOWER LIMB ORTHOPAEDIC SURGERY

ABSTRACT

Pain is common after most surgeries. Poorly treated or uncontrolled

postoperative pain has a lot of consequences, which include; increased

postoperative morbidity, delayed return of normal physiological function,

restriction of mobility with risk of thromboembolism and heightened

cathecolamine response leading to increased oxygen consumption.

A number of adjuncts have been used intrathecally to improve the quality

and duration of post operative analgesia. Among the opioids, tramadol which is

readily available and has less respiratory depressant effect has been used in

different doses with varying results. This study evaluated the effect of

intrathecal tramadol combination with bupivacaine for postoperative pain relief

after lower limb orthopaedic surgery.

This is a randomized double blind study. One hundred and forty-four

patients for various lower limb orthopaedic surgeries under spinal anaesthesia

who gave consent for the study were allotted to three groups (48 in each group).

Group 1(BT4O) received 40 mg of tramadol in addition to 15mg of 0.5%

hyperbaric bupivacaine for the subarachniod block, group 2(BT25) received 25

mg of tramadol plus the same dose of bupivacaine and group 3(B) received only

15mg bupivacaine. The duration of surgery, pain score (using VAS) at various

13

times after the subarachnoid block up to 24 hours, and time of first analgesic

request were recorded. The number of rescue analgesic, duration of motor block,

adverse effects like sedation, nausea, vomiting hypotension, bradycardia were

also recorded.

There was no significant difference in the demographic distribution of

the patients in the groups. The time to first analgesic request, in mean and

standard deviation (duration of analgesia) among the groups were 274.34

±33.79, 241.38 ± 10.5 and190.26 ± 19.34 minutes for groups BT40, BT25, and B

respectively which was statistically significant (p =0.000).There was no

difference in the duration of motor block and duration of surgery among the

groups. There was significant difference in the number of rescue analgesia

within the next 24 hours following the subarachnoid block. The incidence of

side effects was comparable among the groups. Nausea and vomiting although

recorded in the tramadol groups were not statistically significant.

Tramadol added to bupivacaine for subarachnoid block provided post operative

analgesia after lower limb orthopaedic surgery. Tramadol 40mg provided longer

analgesia than 25mg with minimal side effects.

HOW TO RECEIVE PROJECT MATERIAL(S)

After paying the appropriate amount (#5,000) into our bank Account below, send the following information to

08068231953 or 08168759420

(1)    Your project topics

(2)     Email Address

(3)     Payment Name

(4)    Teller Number

We will send your material(s) after we receive bank alert

BANK ACCOUNTS

Account Name: AMUTAH DANIEL CHUKWUDI

Account Number: 0046579864

Bank: GTBank.

OR

Account Name: AMUTAH DANIEL CHUKWUDI

Account Number: 3139283609

Bank: FIRST BANK

FOR MORE INFORMATION, CALL:

08068231953 or 08168759420

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