Comparison of epidural tramadol, tramadol - Droperidol and tramadol-clonidine in the postoperative pain management

Abstract

In this study, tramadol alone and the combinations of tramadol - clonidine and tramadol - droperidol were compared with regard to their effectiveness and side effects. Epidural catheters were placed to 90 ASA I-II group adult patients undergoing lower abdominal surgery, preoperatively through the L3-4 by using loss of resistance method. The first group received 75 mg tramadol (T), the second group received 75 mg tramadol - 2.5 mg droperidol (TD) and the third group received 75 mg tramadol-150 ?g clonidine (TK) in a total volume of 10 ml via epidural route. The time point of initiation and duration of analgesia, visual pain, sedation, nausea scores, blood pressure, heart rate, SpO2 values, respiration rate and side effects were recorded. The durations of analgesia were similar in groups TD and TK and both were significantly longer than group T (p<0.001). Group TK exhibited significant increase in sedation and decrease in blood pressure and heart rate compared to other groups (p<0.01). No side effect was observed in group TD, while significant nausea - vomiting scores were evident in groups T and TK (p<0.001). No significant differences were found between the study groups with regard to the VAS scores, respiration rates, and SpO2 values. In conclusion, it may be suggested that addition of droperidol or clonidine to epidural tramadol may prolong analgesia and when side effects as well as the antiemetic effect were considered, droperidol seems to be a better choice.