Evaluation of continuous epidural tramadol and bupivacaine combination for postoperative analgesia

Objectives: Determine the effectiveness of continuous administration of 0.25 % Bupivacaine and Tramadol in the epidural space for major abdominal and lower limb surgery. Design: In the post operative ward a solution containing 0.25 % Bupivacaine and 0.6 mg Tramadol per milliliter was infused through epidural catheter placed at T12-L1 and L2-L3 space depending on the surgery with a Bard PCA 1 Pump at a rate of 4 ml/hr for 15 to 72 hours. Pain relief was evaluated by VAS at 1st, 4th, 24th, 36th and 48th hours. Subjects: Fifty three patients between 16-76 years of either sex undergoing abdominal and lower limb procedure with ASA status I-III were studied. Results: 56.6 % had 50 % pain relief in the 1st hour and 81 % had well to excellent (70 - 90 %) relief by 4th hour. 3.8 % of patients had urinary retention as complication. The sedation score ranged from 0 - fully awake to SA - normal sleep but easily arousable. Conclusion: The continuous infusion of tramadol and bupivacaine gives good relief in major abdominal and lower limb surgeries with leas side effects.