Tramadol as an adjuvant to ropivacaine in utrasound guided erector spinae plane block for postoperative analgesia after sternotomy

Abstract

Ultrasound guidederector spinae plane (ESP) block is effective in thoracoabdominal surgeries for control of postoperative pain. With the increasing use of adjuvants in local anesthetics, the block duration can be prolonged. A21 year old female patient diagnosed with mediastinal teratoma was planned for resection of tumour through median sternotomy. She was given general anaesthesia with standard drugs. At the end of surgery, patient was given bilateral ultrasound guided ESP block with 10 ml of injection ropivacaine 0.2% with 50 mg tramadol at T5 level on each side. Visual analogue scores (VAS) were in the range of 2-3 for first 24 hours and 1 from 24-48 hours. Patient didn’t demand any analgesic in postoperative period for first 48 hours and was completely painfree. Severe postoperative pain of sternotomy can be controlled effectively by giving ultrasound guided ESP block. Moreover, tramadol is a useful adjuvant to prolong the block duration upto 48 hours.