title: Analgesic effects of intrathecal tramadol in patients undergoing caesarean section: a randomised, double-blind study.
abstract: BACKGROUND
  Intrathecal tramadol combined with local anaesthetics has been used for postoperative analgesia following lower abdominal and perineal surgery. The present study evaluated the effect of intrathecal tramadol on spinal block characteristics and neonatal outcome after elective caesarean section.
  
  
  METHODS
  Eighty full-term parturients scheduled for elective caesarean section were randomly divided into two groups. In the fentanyl group, patients received intrathecal 0.5% bupivacaine 10 mg with fentanyl 10 μg; in the tramadol group, patients were given the same dose of bupivacaine with tramadol 10 mg. Sensory and motor block characteristics, duration of postoperative analgesia, maternal side effects, and neonatal outcome were compared.
  
  
  RESULTS
  One patient in the tramadol group and two patients in the fentanyl group were excluded from data analysis. Median [interquartile range] duration of postoperative analgesia in the tramadol and the fentanyl groups was 300 [240-360] min and 260 [233-300] min respectively (P = 0.02). The incidence of shivering was lower in patients who received tramadol (5%) than those who had fentanyl (32%) (P = 0.003). Apgar scores, umbilical cord acid-base measurement and neurologic and adaptive capacity scores were comparable between the two groups.
  
  
  CONCLUSIONS
  Compared to intrathecal fentanyl 10 μg, tramadol 10 mg, as an adjunct to bupivacaine for subarachnoid block for caesarean section, showed a longer duration of analgesia with a reduced incidence of shivering.
authors: Department of Anaesthesiology, BP Koirala Institute of Health, Dharan, Nepal. Electronic address: subediasish@yahoo.com.
authors: A
authors: A
authors: Subedi
authors: B K
authors: BK
authors: Biswas
authors: M
authors: M
authors: Tripathi
authors: B K
authors: BK
authors: Bhattarai
authors: K
authors: K
authors: Pokharel
mesh_terms: D000328:Adult; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D001034:Apgar Score; D002585:Cesarean Section; D004311:Double-Blind Method; D005260:Female; D005283:Fentanyl / Q000008:administration & dosage; D006801:Humans; D007231:Infant, Newborn; D007278:Injections, Spinal; D011247:Pregnancy; D014147:Tramadol / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D000701:Analgesics, Opioid; D014147:Tramadol; D005283:Fentanyl
keywords: Caesarean section; Spinal anaesthesia; Tramadol