Bupivacaine versus tramadol: a clinical comparison of two anaesthetics administered via epidural route for postoperative analgesic effect in gynaecological surgeries

Md. Arshad Imam, Sabir Hasnat


Background: Gynaecological surgeries are associated with significant postoperative pain. The pain is usually of a long duration. Caudal epidural block has been considered as a procedure of choice for pain relief in such cases. This study was conducted to evaluate postoperative analgesic efficacy of four doses of epidurally administered Bupivacaine versus tramadol in gynaecological surgeries.

Methods: 40 adult cases ranging in age from 20 to 60 years with ASA Grade I & II, presenting for elective gynaecological surgery. Cases were randomly allocated into two groups containing 20 cases each. Cases in Group B received 10ml of 0.25% Bupivacaine and those in Group T received Tramadol 100mg in 10ml of normal saline.

Results: Cases in Group T receiving epidural Tramadol had significant lower pain score on VAS as well as during 24 hours of observation. These cases also had significantly longer dosage intervals compared to Group B cases receiving Bupivacaine. Cardiovascular parameters were stable and similar between both groups.

Conclusions: Epidural Tramadol has better postoperative analgesic efficacy than epidural Bupivacaine. It is a potent and effective postoperative analgesic with rapid onset and minimum side effects.


Analgesic, Bupivacaine, Gynaecological, Epidural, Postoperative, Tramadol

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