A comparison between morphine and tramadol used in combination with ropivacaine for postoperative continuous epidural analgesia

Objective To compare the clinical effect and complication of 0.2% ropivacaine combined with morphine and that with tramadol for postoperative continuous epidural analgesia (CEA). Methods 60 ASAⅠ～Ⅱ patients undergoing lower abdomen operation were randomized into group RM and group RT (30 patients in each group). Group RM was given a 5 ml bolus of 0.2% ropivacaine plus 1 mg of morphine and 0.3 mg of scopolamine, followed by a continuous infusion of 0.2% ropivacaine plus 0.005% morphine at a speed of 2 ml/h. To Group RT, tramadol was given instead of morphine (50 mg in the 5 ml bolus and 0.5% for the continuous infusion). The complications of nausea and vomiting, pruritus, urine retention and respiratory depression were noticed. The analgesic and paralytic effects expressed in VAS and modified Bromage degrees respectively, were recorded 30 min,1,4,8,24 and 48 h after operation. Results There were no significant differences between group RM and group RT in VAS scales and Bromage degree, but the incidences of nausea and vomiting and urinary retention in group RM were obviously higher than in group RT (P0.05). Conclusion 0.2% ropivacaine combined with morphine or tramadol could be safely and effectively used for postoperative analgesia. Because of the lower incidence of complications, the combined use of ropivacaine and tramadol will be more satisfactory.