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Year : 2017  |  Volume : 20  |  Issue : 12  |  Page : 1584-1589

Postoperative analgesia using bupivacaine wound infiltration with intravenous tramadol or dexamethasone following obstetric spinal anaesthesia

1 Department of Anaesthesiology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria
2 Department of Anaesthesia, National Hospital Abuja, Abuja, Nigeria
3 Department of Obstetrics and Gynaecology, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria

Correspondence Address:
Dr. M O Osazuwa
Department of Anaesthesia, National Hospital Abuja, Federal Capital Territory, Abuja
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/njcp.njcp_232_16

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Context: Effective management of postcesarean section (CS) pain is important for the well-being of mother and child; even in limited-resource areas, there are drug options which can be explored to achieve this. Aim: This study aimed to compare the analgesic effects of a combination of bupivacaine wound infiltration with either intravenous (IV) dexamethasone or tramadol after CS. Setting and Design: This study was a randomized, double-blind, comparative study in a tertiary hospital. Clearance obtained from the Institution's Ethics and Research Committee. Methods: One hundred and twenty American Society of Anesthesiologists I or II pregnant women scheduled for CS under spinal anesthesia were recruited after giving consent. At the end of skin closure, all the patients received 20 ml of 0.1% plain bupivacaine for wound infiltration and IV dexamethasone 8 mg (Group BD) or tramadol 100 mg (Group BT). Outcome measures were time to first analgesic request, visual analog scale (VAS) scores, side effects, and patients' satisfaction. Results: Time to first analgesic request was 3.2 ± 1.87 and 3.3 ± 2.01 h for BD and BT groups, respectively (P = 0.778). VAS scores for the first 2 h were lower in the bupivacaine/tramadol group compared to bupivacaine/dexamethasone group; the differences were statistically significant at 30 and 60 min (P = 0.027 and 0.008), respectively. Ninety percent versus 93% of the patients in BD and BT groups, respectively, expressed good to excellent satisfaction with pain relief. Conclusion: Combination of bupivacaine wound infiltration and IV tramadol provided better quality pain relief.

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