A Comparative Study on the Efficacy of Epidural Tramadol versus Fentanyl as Adjuvants to Ropivacaine in Postoperative Pain Management

Abstract

Background: Postoperative pain remains a significant challenge in patient care, leading to various adverse physiological and psychological effects. Effective pain management is crucial for patient recovery and reducing healthcare costs. This study aimed to compare the efficacy and side effects of epidural tramadol versus fentanyl as adjuvants to ropivacaine for postoperative analgesia in lower limb and lower abdominal surgeries.

Methods: A total of 100 adult patients were randomly divided into two groups: Group F received epidural Ropivacaine 0.2% with Fentanyl 25mcg, and Group T received epidural Ropivacaine 0.2% with Tramadol 50mg. Parameters such as onset and duration of analgesia, vital signs (heart rate, mean arterial pressure, respiratory rate), Visual Analogue Scale (VAS) scores, and adverse effects were monitored.

Results: The study found that epidural Ropivacaine 0.2% with Tramadol 50mg provided a significantly longer duration of analgesia compared to Ropivacaine 0.2% with Fentanyl 25mcg, although the onset of action was slower in the tramadol group. Both groups exhibited minimal hemodynamic instability and respiratory depression. However, pruritus and urinary retention were more frequently observed in the fentanyl group.

Conclusion: These findings suggest that epidural tramadol is a viable and potentially superior alternative to fentanyl as an adjuvant to ropivacaine for prolonged postoperative pain relief with a favorable side effect profile.