Esculapio - Volume 16, Issue 04 2020 - www.esculapio.pk - 1 S Esculapio - Journal of Services Institute of Medical Sciences A Comparison between Bupivacaine Alone and Bupivacaine with Tramadol in Epidural Block for Postoperative Pain Management Saadia Khaleeq, 1 Azib Ali, 2 Sahir Shafiq, 3 Muhammad Muazzam Butt, 4 Mudassar Aslam, 5 Muhammad Usman Jehangir 6 Abstract Objective: This study was designed to compare the mean pain score with bupivacaine versus tramadol plus bupivacaine in patients undergoing surgery under general anesthesia. Randomized Controlled Study. Anesthesia department of SIMS medical college/Services Hospital, Lahore. Duration is 13 months from 20th August2017 till 24th September 2018. Method: 80 patients aged 20-60 years of ASA I & II status, undergoing elective surgery were selected. Patients were randomly divided into two groups (Group A and B) of 40 each, using random numbers table. An epidural catheter was placed at L3-L4 intervertebral level. Group A was given 30 ml of 0.125% bupivacaine and Group B was given 25mg Tramadol plus 0.125% bupivacaine mixture in the same volume. General anesthesia was induced with IV Propofol 2mg/kg and atracurium 0.5mg/kg. After recovery from anesthesia, patients were shifted to HDU. Post-operative pain was assessed using the 10-point VAS score. Injection nalbuphine 0.1mg/kg was given as rescue analgesic when VAS score became more than 4. Results: The mean age of patient in Group A was 37.5 ± 9.1 years and 38.6 ± 7.0 years in Group B. Mean BMI in Group A was 33.2 ± 4.3 and 32.2 ± 4.2 in Group B. The mean pain score after 12 hours of surgery was 3.6 ± 0.8 in Group A and 1.5 ± 0.9 in Group B, p value was significant. Conclusion: Thus, the present study concludes that epidural administration of tramadol as adjuvant with bupivacaine is more effective in postoperative pain relief as compared to bupivacaine alone. Key Words: Bupivacaine, Epidural, Postoperative pain, Tramadol. How to Cite: Khaleeq S, Ali A, Shafiq S, Butt M M, Aslam M, Jehangir MU. A Comparison between Bupivacaine alone and Bupivacaine with Tramadol in epidural block for postoperative pain management. Esculapio.2021;17(1): page number. Esculapio.2020;16(04):101-104. DOI: https://doi.org/10.51273/esc20.2516422 Introduction urgical patients require effective intra operative as well as post-operative pain control. The aim of postoperative analgesia is to provide patient comfort, early ambulation and recovery of motor function. 1 Effective postoperative analgesia decreases the inci- dence of respiratory and cardiovascular complica- tions, improves patient satisfaction, speeds up reco- very and discharge from hospital. 2-5 High severity of 1. Saadia Khaleeq 2. Azib Ali 3. Sahir Shafiq 4. Muhammad Muazzam Butt 5. Mudassar Aslam 6. Muhammad Usman Jehangir 1. Department of Anesthesia, Services Institute of Medical Sciences /Services Hospital, Lahore. 2. Cleft Lip and Palate Pakistan Hospital, Lahore. 3. Children Hospital, Faisalabad 4. Pakistan Institute of Neurosciences, Lahore General Hospital Lahore 5. Postgraduate Medical Institute of /Ameer.u.Din Medical postoperative pain increases the incidence of hospital stay duration, surgical morbidity and mortality. 3 Regional analgesia with the local anesthetic drug via epidural catheter is established method of satisfactory postoperative pain management. 1,6 Epidural block gives better control of the level of College,Lahore General Hospital, Lahore 6. Services Institute of Medical Sciences/Services Hospital Lahore Correspondence: analgesia, lesser hemodynamic changes and can be used for postoperative pain relief by using different Dr. Saadia Khaleeq, Assistant Professor Anesthesia, Department of drugs. 6,7 The choice of individual drug used for Anesthesia, Services Institute of Medical Sciences,Services Hospital, Lahore. Email: saadia.raza64@gmail.com Submission Date: 30-09-2020 1st Revision Date: 06-11-2020 Acceptance Date: 08-11-2020 epidural analgesia depends upon the factors like severity of pain, presence of co morbid conditions and general condition of the patient. 4 Bupivacaine is a