Epidural tramadol and bupivacaine in obstetric patients with concurrent cardiac diseases

Abstract

INTRODUCTION: The physiological changes of pregnancy and the stress of labor put added strain on already small cardiac reserve of cardiac patient. Although minimal equipment and expertise is required for regional anesthesia, the sequel of sympathetic blockade does not make it an ideal choice for cardiac patient. The use of low concentration of local analgesic agent with the addition of opioids helps keeping the cardiovascular system stabilized. We used injection tramadol with bupivacaine to study the haemodynamic stability in the obstetric cardiac patients requiring epidural analgesia.

Objective: To determine the haemodynamic stability in cardiac patients during caesarian delivery under epidural analgesia with low dose bupivacaine and tramadol

Design: A descriptive study

Place and duration of Study: This study was conducted in Mother and Child Health Center, Pakistan Institute of Medical Sciences, Islamabad from March 2006 till June 2008.

Methodology: A total of thirty patients suffering from either rheumatic heart disease, cardiomyopathies or ventricular septal defect were given epidural anesthesia. Intra operative hemodynamic parameters were recorded after every three minutes, and the data were analyzed.