Abstract

The aim of this study is to compare between using only ramadol in the spinal block and fentanyl and marcaine combination in the operations on the perineum, genitals, lower extremities and lower abdominal operations, and to study how that affect the analgesia and movement after the operation. A retrospective cohort study was carried out at Tishreen University Hospital. 200 patients were divided into two equal groups: group A: injected by bupivacaine and fentanyl, Group B: injected by tramadol only. Results: The median analgesia time in the tramadol only group was 18 hours, with an estimated range of 20 hours, where the Minima value was 4 hours, while the Maxima value was 24 hours, whereas, in the fentanyl group, the median was 5.5 hours with low range value estimated only 3 hours. Side effects in group B were nearly not existing compared to group A. Movement was intact in Group B and patients were freely able to move the lower extremities. However, patients in group A lost the ability to move the lower extremities for nearly 6 hours which resulted in discomfort. Thus, patients in group B were discharged earlier from the hospital compared to patients in group A.