Epidural tramadol for postoperative pain after Cesarean section

Purpose: To compare the post-operative analgesic effect of 100 mg vs 200 mg epidural tramadol and saline in patients undergoing elective Cesarean sect ion. Methods: Sixty healthy women undergoing Cesarean delivery with epidural ane sthesia were randomly allocated into three groups (n = 20 in each). Patient s received, at skin closure via the epidural catheter, 100 mg tramadol (Gro up 1), 200 mg tramadol (Group II) or 10 ml saline (Control group). Pain sco res and side effects were evaluated at 1, 2, 4, 8, 12 and 24 hr after surge ry. Mean times to the first analgesic administration, as well as the cumula tive doses of analgesic requirements over 24 hr postoperatively were compar ed. Results: The mean time to first analgesic administration was longer in pati ents who received 100 mg tramadol (4.5 +/- 3.1 hr) and the 200 mg tramadol (6.6 +/- 3.4 hr) than in those who received placebo (2.8 +/- 2 hr). The mea n cumulative doses of meperidine over 24 hr were less in the 100 mg tramado l group (0.3 +/- 0.3 mg.kg(-1)) and the 200 mg tramadol group (0.3 +/- 0.3 mg.kg(-1)) than In the control group (0.7 +/- 0.4 mg.kg(-1)). Also, the mea n doses of diclofenac over 24 hr were less in the 100 mg tramadol group (15 6 +/- 59 mg) and the 200 mg tramadol group (142 +/- 62 mg) than in the cont rol group (214 +/- 70 mg), However, no difference was obtained between pati ents receiving 100 mg and 200 mg tramadol concerning all parameters studied . Conclusion: Epidural tramadol 100 mg can provide adequate postoperative ana lgesia without respiratory depression in patients after Cesarean delivery.