Comparison of Preemptive Analgesic Effects of Epidural Tramadol and Morphine

Abstract

In this study we aimed to compare the efficiency of epidural tramadol versus morphine in preemptive analgesia and their side effects. We studied 45 ASA I-II class randomised 20-60 years old patients in three equal groups. After five minutes of the test dose 5 mL of 2 % lidocaine, 100 mg tramadol 75 mg tramadol, 4 mg morphine all diluted in 10 mL saline were administered epiduraly consequetively to the first, second and third group. After ten minutes sensorial block was controlled and anaesthesia induction and intubation was provided with thiopenthone (5 mg/kg), vecuronium (0.08 mg/kg), and fentanyl (2 μg/kg). Anaesthesia was maintained with O2/N2O and isoflurane. No other analgesic were given to the patients intraoperatively. In all patients, the visual analogue pain score was monitored every two hours, PaO2, PaCO2 and respiratory rate were monitored every six hours and SpO2 was continuously monitored every hour for the first 24 hours postoperatively. VAS was not found statistically significant during the first 15 hours among the groups. VAS was significantly different in the morphine group (p<0.01) during the following hours. PaO2, PaCO2 and breathing rates and side effects among all groups were not found statistically significant. We conclude that different doses of epidural tramadol are safe and efficient as a single dose of morphine for postoperative pain relief.