This was a prospective, randomized, placebo-controlled clinical study, comparing intrathecal tramadol with intrathecal pain fentanyl and a normal saline placebo-controlled protocol for visceral pain control during bupivacaine subarachnoid block for open appendectomy. Patients were drawn from those scheduled for emergency open appendectomy requiring subarachnoid block. Ethical clearance and approval were obtained from the institution’s ethical committee. Informed consent of every participating patient was obtained before the study was commenced.