Efficacy of two doses of tramadol versus bupivacaine in perioperative caudal analgesia in adult hemorrhoidectomy

Abstract

Background: The study was conducted to evaluate the perioperative analgesic efficacy of the two doses of caudally administered tramadol versus bupivacaine in adult hemorrhoidectomy. Patients and Methods: A total of 90 patients, aged 20-50 years, undergoing hemorrhoidectomy were randomly scheduled to receive bupivacaine 0.25% in 20 ml (Group B; n = 30), tramadol 1 mg/kg in 20 ml (Group T 1 ; n = 30), tramadol 2 mg/kg in 20 ml (Group T 2 ; n = 30) through caudal route after induction of general anesthesia. Postoperative pain was assessed every hour until the visual analog scale was 6, which is 1 st time for rescue analgesia. Postoperative sedation, hemodynamic changes, serum cortisol, and epinephrine levels and incidence of side effects were also evaluated. Results: Duration of analgesia was longer in Group T 2 (20 [1.14] h] compared with the Group B (7 [1.2] h) or Group T 1 (12 [0.75] h); all P < 0.001. There were no significant hemodynamic changes. There were not incidences of side effects. Conclusion: Caudal tramadol 2 mg/kg provided a longer duration of postoperative analgesia with rapid onset and no incidence of complications or adverse effects in adult hemorrhoidectomy.

Keywords

• Analgesia; bupivacaine; caudal; hemorrhoidectomy; tramadol