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A combination of bupivacaine, an amide local anesthetic, and tramadol, a centrally acting opioid analgesic. This combination is used for postoperative pain management through various administration routes including caudal blocks, epidural administration, and local infiltration. The combination provides superior and prolonged analgesia compared to either agent alone, with bupivacaine blocking sodium channels to prevent nerve impulse transmission while tramadol works through μ-opioid receptor activation and inhibition of serotonin and norepinephrine reuptake.
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