Local infiltration of tramadol versus bupivacaine for post cesarean section pain control: A double-blind randomized study

Background: postoperative pain control after cesarean section (c/s) is important because inadequate postoperative pain control can result in a prolonged hospital stay. in this study,we compared postoperative somatic wound pain control between patients receiving tramadol and bupivacaine,infiltrated at the wound site. methods: in this randomized clinical trial,98 patients,eligible for elective c/s under general anesthesia,were randomly allocated to 2 groups. before wound closure,20 cc of 0.025% bupivacaine and 2 mg/kg of tramadol,diluted to 20 cc,were infiltrated at the wound site in groups a and b,respectively. after surgery,the pain score was measured using the visual analogue scale (vas). additionally,24-hour total morphine consumption,nausea and vomiting,and respiratory depression were compared after 2,4,8,16,and 24 hours between the 2 groups. the data were analyzed using spss with the student independent t test,χ2 test,fisher exact test,and repeated measure test. results: postoperatively,there was no significant difference between these 2 groups in their vas scores until 16 hours (p>0.05). however,at the 16th and 24th hours,the mean vas scores were 3.20±2.24 and 2.51±2.55 in the bupivacaine group and 2.51±0.99 and 1.40±0.88 in the tramadol group,respectively (p<0.05). there was no difference in nausea and vomiting during the 24-hour period between the 2 groups. also,no respiratory depression was detected in the both groups. conclusion: local infiltration of tramadol (2 mg/kg) at the incision site of c/s was effective in somatic wound pain relief without significant complications. © 2017,shiraz university of medical sciences. all rights reserved.