Year : 2015  |  Volume : 8  |  Issue : 3  |  Page : 370-376

Epidural dexmedetomidine, tramadol, or neostigmine for postoperative pain after major breast surgeries

Department of Anesthesia and Intensive Care, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Mohamad H Hamada
8 Family Houses, El Obor City, Qalubia
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1687-7934.161707

Rights and Permissions

Background It is postulated that the beneficial effects of epidural analgesia result from attenuation of stress response and provision of good postoperative analgesia. We added dexmedetomidine, tramadol, or neostigmine to bupivacaine in thoracic epidural anesthesia to evaluate their effect on perioperative cortisol level, postoperative analgesia, time to ambulation, and complications. Patients and methods Eighty female patients scheduled for major breast surgery were divided into four equal groups (20 patients each) in a randomized double-blinded manner. Thoracic epidural anesthesia was induced. In group C 15 ml of 0.5% bupivacaine (control group), in group D 15 ml of 0.5% bupivacaine +75 μg of dexmedetomidine, in group T 15 ml of 0.5% bupivacaine +75 mg of tramadol, and in group N 15 ml of 0.5% bupivacaine +75 μg of neostigmine were given. Perioperative cortisol level, postoperative analgesia, time to ambulation, and complications were assessed. Results Demographic data and surgical characteristics were similar in all groups. Patients in groups D and T had lower pain scores compared with patients in groups C and N at all time points in the following 24 h postoperatively. Hence, patients in groups D and T consumed a lower dose of bupivacaine in the postoperative period compared with patients in groups C and N. There was a highly significant reduction in the mean time to postoperative ambulation in groups D, T, and N compared with group C. Conclusion Dexmedetomidine is superior to tramadol and neostigmine in providing hemodynamic stability, excellent attenuation of stress response, prolonged postoperative analgesia, and early mobilization with minimal undesirable side effects.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded187    
    Comments [Add]    

Recommend this journal