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Year : 2014  |  Volume : 17  |  Issue : 3  |  Page : 324-330

Intrathecal tramadol versus intrathecal fentanyl for visceral pain control during bupivacaine subarachnoid block for open appendicectomy

1 Department of Anaesthesia, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State, Nigeria
2 Department of Anaesthesia,LAUTECH Teaching Hospital, Oshogbo, Osun State, Nigeria
3 Department of Anaesthesia, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

Correspondence Address:
J M Afolayan
Department of Anaesthesia, Ekiti State University Teaching Hospital, Ado Ekiti, Ekiti State
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1119-3077.130234

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Context: Profound side-effects following intrathecal use of local anesthetics as the sole drugs of choice make spinal anesthesia for open appendicectomy uncommon. Aim: The aim of this study was to evaluate the effectiveness of intra-operative analgesia produced by intrathecal tramadol and fentanyl during bupivacaine spinal anesthesia for open appendicectomy. Settings and Design: A prospective randomized study was performed. Materials and Methods: A total of 186 American Society of Anesthesiologists 1 or 11 patients scheduled for emergency open appendicectomy were analyzed. Group FB ( n = 62) received intrathecal fentanyl 25 μg plus 3 ml of 0.5% hyperbaric bupivacaine, Group SB ( n = 62) received 0.5 ml normal saline plus 3 ml of 0.5% hyperbaric bupivacaine and Group TB ( n = 62) received intrathecal tramadol 25 mg plus 3 ml of 0.5% hyperbaric bupivacaine. Visual analog scale scores and frequency of subjective symptoms among patients in the three groups formed the primary outcome measure of this study. Results: Effective intraoperative sensory block was achieved in 100% of patients in group FB and TB while 29 (46.8%) patients in group SB had ineffective sensory block ( P = 0.0001). The pain free period was significantly longer in patients in Group FB than Group SB and TB. Mean time for Group FB with regard to first analgesic request was 304.73 ± 67.91 min, Group SB was 146.59 ± 36.62 and Group TB was 238.39 ± 61.28 min. Incidence of complications were comparable among the three groups. Conclusion: This study showed that intrathecal tramadol (25 mg) can safely replace intrathecal fentanyl (25 μg) in the management of visceral pain and discomfort during subarachnoid block for appendicectomy.

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