COMPARISON OF TRAMADOLAS AN ADJUVANT TO INTRATHECAL ISOBARIC LEVOBUPIVACAINE FOR ELECTIVE LOWER LIMB SURGERIES UNDER SPINAL ANESTHESIA

Abstract

Background: Long acting local anesthetics are used in subarachnoid block to increase the duration of anesthesia. Adjuvants are added to improve the duration of analgesia. The objective of this study was to evaluate the efcacy of tramadol as an intrathecal adjuvant to levobupivacaine in terms of duration of analgesia, onset of sensory blockade, onset of motor blockade, and duration of motor blockade. Methodology: After obtaining the Institutional Ethical Committee approval and informed consent, sixty patients posted for infraumbilical surgeries were recruited. Randomization was done using a sealed envelope technique. Patients were divided into two groups: LTreceived 2.5 ml of 0.5% isobaric levobupivacaine with tramadol 25 mg (0.5 ml) and LS received 2.5 ml of 0.5% isobaric levobupivacaine with 0.5 ml of normal saline. Duration of analgesia, onset of sensory blockade, and onset and duration of motor blockade were recorded. Results: There was no statistical difference in demographic data between the two groups. The mean onset time of sensory blockade in Group LS was 7.17±3.07 min and for Group LT was 8.53 ± 2.47 min, which was not statistically signicant between two groups (P = 0.064). The mean onset time of motor blockade in Group LS was 9.76 ± 3.18 min and for Group LT was 11.23 ± 2.47 min, which was statistically signicant between the two groups (P = 0.050). The mean time duration of analgesia in Group LS was 265.60± 39.18 min and for LT was 304.30 ± 24.88 min. There was mild prolongation of analgesia in Group LT, but it was statistically signicant (P <0.001). The mean duration of motor blockade in Group LS was 197.93 ± 4.41 min and Group LT was 236.20 ± 33.89 min, which was statistically signicant between the two groups (P <0.001). Conclusion: Tramadol as an adjuvant to isobaric intrathecal levobupivacaine does prolong analgesia signicantly.