Epidural fentanyl for post-operative analgesia in lower limb orthopaedic surgeries: A comparative study with epidural tramadol
European Journal of Molecular & Clinical Medicine,
2023, Volume 10, Issue 2, Pages 1894-1902
AbstractTo compare the efficacy of epidural FENTANYL and TRAMADOL for post-operative analgesia in lower limb surgeries in terms of onset of analgesia, duration of analgesia, quality of analgesia and undesirable effect.
Material Method: This prospective randomized study was conducted to compare the analgesic efficacy and side effects of epidural fentanyl and that of epidural tramadol and included sixty (60) patients of either sex in the age range of 18-65 years, undergoing lower limb surgeries under Combined Spinal Epidural anaesthesia (CSE) with ASA physical status I & II. These were divided into two groups of 30 patients each. Group F- Fentanyl group and Group T- Tramadol group. Patients of Group F received 50 mcg of Fentanyl + 8ml of 0.125% Bupivacaine (9 ml) and that of Group T received 50 mg of Tramadol and 8ml of 0.125% Bupivacaine(9 ml).The patients were randomly given epidural fentanyl or epidural tramadol when patient complained of pain post operatively with Visual analog score 3 or above. Patients were closely monitored in the post-operative period till they had pain relief. Quality of pain relief was measured using visual analogue scale and occurrence of side effects like nausea and vomiting, pruritis, respiratory depression were noted.A detailed clinical history and physical examination of the patients was done and all vital parameters were recorded well in advance. An informed and written consent was taken from the patient for the study.
Result: Mean Time of onset of analgesia after epidural injection was 5.42 ± 1.18 minutes in Group F and 12.80 ± 1.62 minutes in Group T and the difference was found to be statistically significant. Mean Duration of analgesia was 240.22 ± 36.53 in Fentanyl group and 360.52 ± 24.83 in Tramadol groups respectively which was also statistically significant. Pruritis was significantly higher in Fentanyl group whereas nausea and vomiting was higher in tramadol group. Quality of analgesia was better following administration of epidural Fentanyl.
Conclusion: Both epidural Fentanyl and Tramadol are effective in relieving post-operative pain; however Fentanyl produced better patient satisfaction compared to tramadol but the duration of action was short.
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