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Epidural tramadol for postoperative pain after Cesarean section

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To compare the post-operative analgesic effect of 100 mgvs 200 mg epidural tramadol and saline in patients undergoing elective Cesarean section.


Sixty healthy women undergoing Cesarean delivery with epidural anesthesia were randomly allocated into three groups (n = 20 in each). Patients received, at skin closure via the epidural catheter, 100 mg tramadol (Group I), 200 mg tramadol (Group II) or 10 ml saline (Control group). Pain scores and side effects were evaluated at 1, 2, 4, 8, 12 and 24 hr after surgery. Mean times to the first analgesic administration, as well as the cumulative doses of analgesic requirements over 24 hr postoperatively were compared.


The mean time to first analgesic administration was longer in patients 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 mean cumulative doses of meperidine over 24 hr were less in the 100 mg tramadol 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 mean doses of diclofenac over 24 hr were less in the 100 mg tramadol group (156 ± 59 mg) and the 200 mg tramadol group (142 ± 62 mg) than in the control group (214 ± 70 mg). However, no difference was obtained between patients receiving 100 mg and 200 mg tramadol concerning all parameters studied.


Epidural tramadol 100 mg can provide adequate postoperative analgesia without respiratory depression in patients after Cesarean delivery.



Comparer l’effet analgésique postopératoire de 100 mg vs 200 mg de tramadol épidural ou d’une solution salée chez des patientes qui doivent subir une césarienne.


Soixante femmes en santé admises pour une césarienne sous anesthésie épidurale ont été réparties au hasard en trois groupes (n = 20 chacun). Elles ont reçu, lors de la fermeture cutanée et au moyen d’un cathéter épidural, 100 mg (groupe I) ou 200 mg (groupe II) de tramadol ou 10 ml de solution salée (groupe témoin). Les scores de douleur et les effets secondaires ont été évalués à 1, 2, 4, 8, 12 et 24 h après l’intervention. On a comparé les temps moyens de la première administration d’analgésique et quelles en étaient les doses cumulatives postopératoires demandées pendant 24 h.


Le temps moyen pour la première analgésie a été plus long chez les patientes qui ont reçu 100 mg (4,5 ±3,1 h) ou 200 mg (6,6 ± 3,4 h) de tramadol que chez celles qui n’ont reçu que le placebo (2,8 ± 2 h). Pendant 24 h après la césarienne, les doses moyennes cumulatives de mépéridine ont été moindres dans les groupes I et II (0,3 ± 0,3 mg·kg−1; 0,3 ± 0,3 mg·kg−1) que dans le groupe témoin (0,7 ± 0,4 mg·kg−1) et les doses moyennes de diclofénac ont été plus faibles dans les groupes I et II (156 ± 59 mg; 142 ± 62 mg) que dans le groupe témoin (214 ± 70 mg). Cependant, aucune différence n’a été notée entre les patientes des groupes I et II, et ce, pour tous les paramètres étudiés.


Ladministration épidurale de 100 mg de tramadol peut fournir une analgésie postopératoire adéquate sans dépression respiratoire chez des patientes qui ont subi une césarienne.


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Correspondence to Anis Baraka.

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Siddik-Sayyid, S., Aouad-Maroun, M., Sleiman, D. et al. Epidural tramadol for postoperative pain after Cesarean section. Can J Anesth 46, 731 (1999). https://doi.org/10.1007/BF03013907

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  • Morphine
  • Tramadol
  • Cesarean Delivery
  • Respiratory Depression
  • Epidural Catheter