Post- Operative Analgesic Effect of Intra- Peritoneal 0.5% Ropivacaine With and Without Tramadol in Laparoscopic Abdominal Surgeries

Background: Managing postoperative pain is essential in laparoscopic abdominal surgeries to enhance recovery, minimize complications, and reduce hospital stays. Intraperitoneal administration of local anesthetics like ropivacaine has become a popular approach to managing visceral and somatic pain post-surgery. Recent studies suggest that combining local anesthetics with opioids like tramadol can further improve pain relief, although it might be linked to adverse symptoms including nausea. Aim: To assess the intraperitoneal 0.5% ropivacaine’s postoperative analgesic efficacy in laparoscopic abdominal procedures in terms of pain scores, the need for rescue analgesia, and side effect profiles, both with and without tramadol. Methods: A randomised controlled trial with double blinding was carried out on 100 patients receiving laparoscopic abdominal surgery in a prospective manner. Patients were randomly assigned to Group A (15 ml of 0.5% ropivacaine with 15 ml saline) or Group B (4 ml tramadol, 15 ml of 0.5% ropivacaine, and 11 ml saline). At several times after surgery, pain was assessed using the Visual Analogue Scale (VAS). The duration of the first rescue analgesia, the total amount of analgesics used, and any side effects were noted. An analysis using statistics was done. Results: Group B (ropivacaine + tramadol) had significantly lower VAS pain scores compared to Group A (ropivacaine alone) at most time intervals, particularly during the first 12 hours post-surgery (p < 0.05). Group B also required significantly less rescue analgesia and had lower total morphine consumption within 24 hours (p < 0.001). While nausea was more common in Group B (12% vs 2% in Group A, p = 0.045), no other significant adverse effects were observed. Conclusion: Better pain management is achieved in the early postoperative phase when intraperitoneal 0.5% ropivacaine plus tramadol is used instead of ropivacaine alone. Although this combination is linked to a higher rate of nausea, it is a useful strategy for managing pain after laparoscopic procedures since it lowers the requirement for rescue analgesia and the overall amount of opioids used. Recommendations: Further research is recommended to optimize tramadol dosing to balance effective pain relief with minimal side effects. This combination therapy could be integrated into enhanced recovery protocols to improve patient outcomes post-laparoscopic surgery.