Evidence map›Paper›PMID 41223203›Full record

Trial reportPloS one2025

Analgesic effectiveness of wound infiltration with bupivacaine versus a mixture of bupivacaine and tramadol for postoperative pain management among parturients undergoing elective cesarean section under spinal anesthesia: A randomized controlled trial.

Mesay Milkias, Semagn Mekonnen, Hailemariam Getachew, Hailemariam Mulugeta, Siraj Ahmed, Melkamu Kebede, Belete Destaw, Medhanit Melese, Zemedu Aweke

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Mesay MilkiasDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.ORCID https://orcid.org/0000-0002-0554-5400
Semagn MekonnenDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Hailemariam GetachewDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Hailemariam MulugetaDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Siraj AhmedDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Melkamu KebedeDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Belete DestawDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Medhanit MeleseDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.
Zemedu AwekeDepartment of Anesthesia, Dilla University College of Medicine and Health Sciences, Dilla, Ethiopia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPost-operative pain is among the major post-cesarean problems, with an incidence ranging from 25.5% to 80%. Despite its simplicity, the effectiveness of wound infiltration with a mixture of bupivacaine and tramadol is still unknown. Therefore, this study aims to compare the analgesic effectiveness of wound infiltration with bupivacaine versus a combination of bupivacaine and tramadol for postoperative pain management among parturients undergoing cesarean section under spinal anesthesia. METHODOLOGY: A double-blind, parallel, randomized controlled trial was conducted on 60 parturients. Parturients were randomized to take either bupivacaine (B = 30) or a combination of bupivacaine and tramadol (BT = 30). The homogeneity of variance was assessed using Levene's test, and normality was assessed using the Shapiro-Wilk test. A numeric rating scale was used to measure pain severity. The independent t-test and the Mann-Whitney U test were used, respectively, for parametric and non-parametric data. A generalized estimating equation was used to assess repeated measurements.

resultIn total, 60 parturients were analyzed with no dropouts. The severity of pain at the 6th hour was six times greater in the B group compared to the BT group (OR = 6.289, CI, 2.097-18.858, P = 0.001). The mean tramadol consumption was lower in the BT group (140.00 ± 48.066 mg) than in the B group (175.00 ± 34.114 mg), with a statistically significant mean difference of 10.761 (95% CI, 13.459 to 56.541), t (58) = 3.252, P = 0.002, (d = 0.839). The mean first analgesia request time was higher in the mixture of the BT group (367.33 ± 50.099 min) than in the B group (216.33 ± 68.744 min), with a statistically significant difference of 15.530 (95% CI, -182.087 to -119.913), t (58) = 5.6553, P = 0.001.

conclusionWound infiltration with a combination of bupivacaine and tramadol is more effective than bupivacaine alone for postoperative analgesia in pregnant patients who underwent cesarean section under spinal anesthesia. This clinical trial study was registered at the Pan African Clinical Trial Registry with a unique trial registration number of PACTR202310525672884 (13/10/2023).

Indexed as

Analgesics, OpioidAnesthesia, SpinalAnesthetics, LocalBupivacaineCesarean SectionPostoperative PainTramadolAdultDouble-Blind MethodFemaleHumansPain MeasurementPregnancyAnalgesics, OpioidAnesthetics, LocalBupivacaineTramadol

Identifiers

PMID41223203
PMCPMC12611141

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.