Evaluation of Anesthetic and Analgesic Effects of Intrathecal Administration of Tramadol vs Fentanyl

Objectives: The aim of this study was to examine the anesthetic and analgesic effects of intrathecal tramadol compared with intrathecal fentanyl added to bupivacaine and that of a placebo added to bupivacaine in patients undergoing elective transurethral procedures.
Methods: The anesthetic and analgesic efficacy of intrathecal tramadol hydrochloride (HCL) was assessed against a local anesthetic in this prospective, double-blind, randomized study of 146 American Society of Anesthesiologists classification I-III patients who underwent an elective transurethral procedure. A lumbar intrathecal block was performed using bupivacaine heavy 0.5 % combined with either tramadol HCL, fentanyl, or saline for surgery. Each group received 12.5 mg bupivacaine with 50 μg (1 mL) fentanyl, 12.5 mg bupivacaine with 10 mg (1 mL) tramadol, or 12.5 mg bupivacaine with 1 mL preservative-free saline.
Results: The saline group experienced more pain than patients in the tramadol HCL and fentanyl groups (p<0.05). The mean time to regression of the sensory block to the S1-2 segment was significantly longer in the fentanyl group compared with the tramadol and saline groups (p<0.05). The incidence of complications was similar.
Conclusion: Fentanyl added to a local anesthetic provided longer postoperative analgesia compared with tramadol added to a local anesthetic.

Ýntratekal Tramadol Ve Fentanil Yönetiminin Anestetik Ve Analjezik Etkilerinin Deðerlendirilmesi

Amaç:
Bizim amacýmýz, elektif transüretral prosedür uygulanan hastalarda intratekal tramadolün bupivakaine eklenen fentanil ve bupivakaine eklenen plasebo ile karþýlaþtýrýldýðýndaki anestezik ve analjezik etkilerini gözlemlemektir.
Gereç ve Yöntem:
Elektif transüretral prosedür uygulanan ASA I-III 146 hastanýn dahil edildiði prospektif, çift kör, randomize çalýþmada intratekal lokal anestetik ile tramadol HCL’nin anestetik ve analjezik etkinliðini deðerlendirdik. Lomber intratekal blok, cerrahi için %0,5 Heavy Bupivakain tramadol HCL, fentanil veya salin ile kombine edilerek uygulandý. Her bir gruba, 12.5mg bupivakain ile 50μg (1ml) fentanil (F), 12.5mg bupivakain ile 10mg (1ml) tramadol (T) or 12.5mg bupivakain ile 1ml koruyucu serbest salin (S) verildi.
Bulgular:
Salin grubunda Tramadol HCL ve fentanil gruplarýndan daha çok hasta aðrý deneyimledi (p<0.05). Fentanil Grubunda tramadol ve salin gruplarýyla karþýlaþtýrýldýðýnda S1-2 segmentinden gerileme ortalamasý daha uzundu (p<0.05). Komplikasyon görülme sýklýðý benzerdi.
Sonuç:
Fentanil eklenen lokal anestestetiklerin postoperatif analjezi süresinin tramadol eklenen lokal anestetiklerle karþýlaþtýrýldýðýnda daha uzun olduðu sonucuna vardýk.