A comparative study on the analgesic effect of tramadol or magnesium sulfate added to bupivacaine infiltration for postoperative pain management after lumbar disk surgeries

Background Postoperative pain management aims to reduce patient discomfort and to allow early mobilization and recovery. Local anesthesia infiltration is a safe and effective anesthetic technique for many surgical procedures. Aim The aim of this study was to compare the effectiveness of local wound...

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Bibliographic Details
Published in:Tanta Medical Journal 2018-07, Vol.46 (3), p.203-209
Main Authors: Ahmed, Soliman, Dowidar, Abd El-Raheem, Al Zeftawy, Ashraf, Ramadan SN, Sameh Mohamed, Mostafa, A, Al Sayed, A, Mohamed, S
Format: Article
Language:English
Subjects:
Analgesia
Anesthesia
Atracurium
Bupivacaine
Care and treatment
Comparative literature
Magnesium compounds
Magnesium sulfate
Pain management
Postoperative pain
Sulfates
Wounds
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Summary:Background Postoperative pain management aims to reduce patient discomfort and to allow early mobilization and recovery. Local anesthesia infiltration is a safe and effective anesthetic technique for many surgical procedures. Aim The aim of this study was to compare the effectiveness of local wound infiltration of bupivacaine plus tramadol and bupivacaine plus magnesium sulfate for postoperative analgesia after lumbar disk surgeries. Design A randomized double-blind study was conducted. Setting The study was conducted at Tanta University Hospitals, Neurosurgical Department. Patients Sixty patients of either sex from 18 to 65 years old and undergoing elective lumbar disk surgery were included in the study. Patients and methods Patients were randomized preoperatively into three equal groups of 20 patients each. The patients of group I (bupivacaine group) received 20-ml solution containing bupivacaine 0.5% (10 ml), constituted with normal saline; the patients of group II (bupivacaine-magnesium group) received 20-ml solution, containing bupivacaine 0.5% (10 ml) with 500 mg of magnesium sulfate (5 ml) constituted with normal saline; and the patients of group III (bupivacaine-tramadol group) received 20-ml solution containing bupivacaine 0.5% (10 ml) with 2 mg/kg of tramadol constituted with normal saline. Postoperative pain as assessed using visual analog scale, and the time to first analgesic requirement and the total dose of rescue analgesia in the first 24 h postoperatively were also recorded. Results Wound infiltration with both tramadol and magnesium added to bupivacaine has provided a better pain control compared with bupivacaine alone. Visual analog scale values were significantly higher in group I than groups II and III at 4 h. First dose of supplemental analgesic was later in group III in comparison with groups II and I. Pethidine consumption was lowest in group III compared with the other two groups. Conclusion Local wound infiltration with a mixture of bupivacaine and tramadol after lumbar disk surgery produced an effective analgesia with reduced postoperative opioid requirements and minimal adverse effects compared with the other two groups.
ISSN:1110-1415
2314-8624
DOI:10.4103/tmj.tmj_57_17