Analgesic effects of intrathecal tramadol in patients undergoing caesarean section: a randomised, double-blind study
International Journal of Obstetric Anesthesia , 08/20/2013 Clinical Article
Subedi A et al. – Intrathecal tramadol combined with local anaesthetics has been used for postoperative analgesia following lower abdominal and perineal surgery. The present study evaluated the effect of intrathecal tramadol on spinal block characteristics and neonatal outcome after elective caesarean section. Compared to intrathecal fentanyl 10µg, tramadol 10mg, as an adjunct to bupivacaine for subarachnoid block for caesarean section, showed a longer duration of analgesia with a reduced incidence of shivering.
- Eighty full–term parturients scheduled for elective caesarean section were randomly divided into two groups.
- In the fentanyl group, patients received intrathecal 0.5% bupivacaine 10mg with fentanyl 10µg; in the tramadol group, patients were given the same dose of bupivacaine with tramadol 10mg.
- Sensory and motor block characteristics, duration of postoperative analgesia, maternal side effects, and neonatal outcome were compared.
- One patient in the tramadol group and two patients in the fentanyl group were excluded from data analysis.
- Median [interquartile range] duration of postoperative analgesia in the tramadol and the fentanyl groups was 300 [240–360]min and 260 [233–300]min respectively (P=0.02).
- The incidence of shivering was lower in patients who received tramadol (5%) than those who had fentanyl (32%) (P=0.003).
- Apgar scores, umbilical cord acid–base measurement and neurologic and adaptive capacity scores were comparable between the two groups.