A comparative study of oral tapentadol with thoracic epidural analgesia versus intravenous tramadol and paracetamol combination for postoperative analgesia in off pump CABG

Background: Accurate management of post operative pain is quite impossible with single drug therapy approach. For this, our aim was to combine use of tapentadol tablet orally along with thoracic epidural in comparison with intravenous combined use of tramadol, paracetamol and diclofenac for postoperative analgesia in case CABG patients. Methods: 60 patients of CABG (Coronary Artery Bypass Surgery) randomly and equally divided into two groups. Group TTE (Tab. Tapentadol -Thoracic Epidural, n=30) were given oral Tablet Tapentadol through NG (Nasogastric) tube at the time of shifting the patient from Operation Theatre to postoperative ward along with Tramadol through Thoracic epidural catheter. In Group TPD (Tramadol -Paracetamol -Diclofenac, n=30) were given Inj. Tramadol, Inj. Paracetamol IV at time of shifting of patient. If pain score is too high (>4) then additional analgesia were given with Diclofenac only if preoperative renal and hepatic profile were normal. Patients were monitored for duration of rescue analgesia, total no. of doses of analgesics in first 72 hours, total consumption of analgesics and response to physiotherapy. Results: Duration of need of rescue analgesia was significantly longer in TTE group (p