lower limb surgeries.

Compare the epidural bupivacaine alone and bupivacaine with tramadol in lower limb surgeries. The patients were randomly divided into two groups with 50 patients in each group as under: Group I (Bupivacaine): These patients received 20ml of 0.5% Bupivacaine + 1 ml of normal saline total volume 21ml administered through epidural route. Group II (Bupivicaine Tramadol): These patients received 20ml of 0.5% Bupivacaine + 1 ml of Tramadol (50mg) total volume (21ml) administered through epidural route. The parameters studied were onset of action, quality of anaesthesia, degree of motor blockade, duration of analgesia, hemodynamic alterations, intraoperative and postoperative complications. Mean onset of action was comparable in both groups. Quality of surgical anaesthesia was excellent in both groups. All patients in group I (Bupivacaine) and group II (Bupivacaine Tramadol) reached Bromage grade I. Duration of analgesia was prolonged in group II (Bupivacaine – Tramadol) as compared to group I (Bupivacaine). Group II (Bupivacaine Tramadol) remained superior to group I (Bupivacaine) in respect of duration of analgesia. In group I Bupivacaine 1 (2%) patient developed hypotension and none of the patient had bradycardia. Two (4%) patients developed nausea. Two (4%) developed shivering. None of the patients had intraoperative vomiting. In group II (Bupivacaine Tramadol) 1 (2%) patient developed hypotension and none of the patient had bradycardia. 2(4%) patients developed nausea. None of the patient had intraoperative vomiting. None of the patients had shivering. None of the patient in any study group developed postoperative nausea, vomiting, postdural puncture headache or backache. Tramodol is a safe and effective adjuvant to epidural bupivacaine for prolongation of total duration of analgesia in lower limb surgeries.