Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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A Prospective, Randomized, Single Blinded Comparative Study of Intrathecal Fentanyl and Tramadol as Adjuvants in Inguinal Hernia Repair Surgery Under Spinal Anaesthesia
Abhisek Mukherjee, Sounak Ray, Amit Kumar and Titisa Mitra
Page: 24-27 | Received 25 Sep 2023, Published online: 04 Jan 2024
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Abstract
Because of its extended duration of action, hyperbaric bupivacaine hydrochloride spinal anesthesia is a preferred choice for longer treatments. It is necessary to extend the duration of postoperative analgesia by adding opioid as an adjuvant, but only by intensifying and lengthening the sensory blockade without lengthening the motor blockade. The purpose of this study is to quantitatively investigate how long‐term and recovery‐oriented the effects of adding fentanyl and tramadol to hyperbaric bupivacaine hydrochloride affect sensory and motor blockage. To assess the effects of spinal anesthesia and the amount of opioids consumed by two groups by comparing the effects of motor and sensory block with the use of fentanyl and tramadol as adjuvants with bupivacaine. To contrast the negative consequences of post‐operative analgesia between two groups. Fifty patients, all male, ages 18‐65 Physical status 1 and 2 of the American Society of Anaesthesiology criteria for elective inguinal hernia repair were randomly assigned into 3 groups. Spinal block with 0.5% Bupivacaine Hydrochloride (hyperbaric) 2mL and 25 μg Fentanyl. Total = 2.5mL Spinal block with 0.5% Bupivacaine Hydrochloride (hyperbaric) 2mL and 25mg tramadol. Total = 2.5mL. Spinal block with 0.5% Bupivacaine Hydrochloride (hyperbaric) 2ml and 0.5ml normal saline total = 2.5mL as “control”. Electrocardiography, noninvasive blood pressure monitoring, and pulse oximetry were used to continually monitor the patients. Before the spinal injection, the patient’s baseline arterial blood pressure and heart rate were measured in a supine posture by a consultant anesthesiologist who was not participating in the study. Following spinal anesthesia, all patients were placed in a supine position and their mean arterial pressure (MAP) and pulse rate were monitored at 5, 10, 15, 30, 60, 120 and 180 min as well as at 6, 12 and 24 hrs. The degree of sensory blockage was measured by cold touch using a cotton ball soaked in spirit, and it was measured with a 23G hypodermic needle just after the subarachnoid block (SAB) and at 5, 10, 15, 30, 60, 120, 180 min. The Bromage scale was also used to measure the degree of motor blockage immediately following SAB as well as at 0,5,10,15,30,60,120 and 180 min, as well as at6,12, and 24 hrs. The following adverse effects have been documented during the perioperative and postoperative phases as a result of intrathecal fentanyl and tramadol administration. Symptoms as nausea, vomiting, pruritis, shivering, respiratory depression (RR<10), hypotension, drowsiness and urine retention, as well as desaturation or hypoxemia (SpO2 <90%). Groups A and B require a lower total rescue analgesia dose than group C. Groups A and B experience a longer sensory recovery than group C. Group A experiences motor blockade for a longer period of time than groups B and C. When intrathecal fentanyl or tramadol was added to bupivacaine, the same hemodynamic alterations were observed, along with adequate post‐operative analgesia and prolonged sensory blocking but the recovery of motor function was not delayed. There were very few intraoperative and postoperative adverse effects when both opioids were added.
How to cite this article:
Abhisek Mukherjee, Sounak Ray, Amit Kumar and Titisa Mitra. A Prospective, Randomized, Single Blinded Comparative Study of Intrathecal Fentanyl and
Tramadol as Adjuvants in Inguinal Hernia Repair
Surgery Under Spinal Anaesthesia.
DOI: https://doi.org/10.36478/10.59218/makrjms.2024.4.24.27
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2024.4.24.27