الفهرس 
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Abstract
This study was a clinical prospective comparative study that was designed to evaluate and compare the postoperative analgesic efficacy of intrathecal tramadol versus fentanyl in elective lower abdominal surgeries and the patients were randomly divided to three groups 40 patients in each group. Patients received 30 µg fentanyl, 30 mg tramadol and the last group is the control group.
We observed that:
• As regard the Mean blood pressure the fentanyl group was highest group, followed by the control group and lastly the tramadol group but was statistically significant only during the first 30 minutes between (the tramadol and the control groups) and (the fentanyl and the control groups) then became non-significant.
• As regard the Heart rate it was statistically non-significant either among all the groups or between each two individual groups.
• As regard the SO2 it was statistically non-significant either among all the groups or between each two individual groups
• As regard the complications Pruritus was the highest in the tramadol group followed by the fentanyl and the control groups
• As regard Nausea and Vomiting it was more common in the fentanyl and the tramadol groups than the control group
• No patient in the three groups suffered from other complications (respiratory depression, itching, shivering, desaturation, hypotension and bradycardia)
• As regard the VAS it was statistically significant in the control group immediately and till 12 hours postoperatively compared to its values in both the fentanyl and tramadol groups. VAS values were statistically non-significant between fentanyl and tramadol groups all over the study period. However at 12-24 hours postoperatively, all the groups showed non-significant statistical differences.
CONCLUSION
• In conclusion, the addition of tramadol 30 mg or fentanyl 30 µg to intrathecally injected local anesthetics improved the postoperative analgesic effect and duration without significant changes in patients’ hemodynamics, arterial oxygen saturation with no serious complications when certain safety measures were taken.