الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
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Abstract
The aim of this study was to evaluate the effect of intraincisional local infiltration of meperidine with bupivacaine versus tramadol with bupivacaine for cases of elective cesarean section under spinal anaesthesia as regards: hemodynamic parameters, visual analogue scale of pain, the need of additional intravenous opioids, sedation score and side effects of either drug.
The present study was carried out in El-Shatby Hospital on a total number of 75 healthy full term pregnant females, American Society of Anaesthetists (ASA) physical status I and II, scheduled for elective caesarean section under spinal anaesthesia, after the approval of The Ethical Committee of the Faculty of Medicine and with written informed consent.
Patients were randomly categorized into three equal groups (25 patients each); Group (I) receiving subcutaneous meperidine with bupivacaine, Group (II) receiving subcutaneous tramadol with bupivacaine and Group (III) receiving subcutaneous bupivacaine.
Preoperative evaluation was done by complete history taking, physical examination and necessary laboratory investigations. Standard monitoring was established: ECG for heart rate and rhythm, non-invasive measurement of arterial blood pressure and arterial oxygen saturation.
Female patients were given intravenous Ringer’s acetate solution 10 ml/kg as volume preload. Spinal anesthesia was performed in the sitting position at the lumbar interspace (L3-L4) with 25 mcg Fentanyl added to (1.7 - 2 ml) of hyperbaric bupivacaine 0.5% according to the pregnant height using 25 gauge needle under complete aseptic technique.