The maternal and neonatal effects of adding tramadol to 2% lidocaine in epidural anesthesia for cesarean section.
BACKGROUND
Opioid analgesics are commonly added to epidural local anesthetics to improve analgesia during surgery.


OBJECTIVE
The goal of this study was to evaluate the maternal and neonatal effects of adding different doses of tramadol to 2% lidocaine in the epidural anesthesia for cesarean section.


METHODS
Ninety pregnant patients who were candidates for cesarean section under epidural anesthesia were randomly categorized into three groups. Group L received 2% lidocaine. In the LT50 and LT100 groups, 50 and 100 mg of tramadol were added to epidural 2% lidocaine. For additional analgesia during surgery, 2% lidocaine through epidural catheter or IV sufentanil were administered. Analgesia after surgery was provided by IV injection of meperidine. Onset and duration of sensory and motor blockades, total drug consumption, neonatal Apgar score, and complications were recorded.


RESULTS
In the LT100 group, onset of complete sensory and motor blockade at T6 was less than in the two other groups, but the highest level of sensory blockade and two segment regression and duration of motor blockades between the LT50 and LT100 groups were not significantly different, although they were higher and more prolonged than in the L group. Average lidocaine and sufentanil consumption during surgery between the LT50 and LT100 groups were not significantly different but were lower than in the L group. The incidence of maternal complications and neonatal Apgar scores were not significantly different between the three groups. In the LT50 and LT100 groups, the time until the first request for analgesics after surgery was prolonged, and average meperidine consumption was less than in the L group.


CONCLUSIONS
The addition of tramadol to epidural 2% lidocaine offers advantages in cesarean section.
Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
Farnad
F
Imani
Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
Saeid Reza
SR
Entezary
Department of Anesthesiology and Pain Medicine, Rasoul-Akram Medical Center, School of Medicine, Tehran University of Medical Sciences, Tehran, IR Iran.
Mahmoud Reza
MR
Alebouyeh
Department of Anesthesiology, Texas Tech University, Health Science Center, Lubbock, Texas, USA.
Suzan
S
Parhizgar
Cesarean section; Epidural anesthesia; Lidocaine; Tramadol