Suresh C1, Rajlaxmi V2
BACKGROUND AND OBJECTIVES: Adjuncts to local anaesthetics for brachial plexus block may enhance the quality and duration of analgesia. Tramadol a synthetic 4-phenylpiperidine analog of codeine is known to produce antinociception and enhance the effect of local anaesthetics when given epidurally, intrathecally or in various peripheral nerve blocks. The purpose of this study was to assess the effect of Tramadol added to brachial plexus block by supraclavicular approach.
METHODS: A prospective, randomized, single blinded study was conducted on 60 ASA I or II adult patients undergoing upper limb surgeries under supraclavicular brachial plexus block. Patients were randomly divided into two groups. Patients in Group I (n=30) were given 38mL of 0.25% Bupivacaine plus 2ml NS and Group II (n = 30) were given 38 mL of 0.25% Bupivacaine plus 2 ml Tramadol (2mg/kg). The onset time and duration of sensory and motor blockade were recorded. Haemodynamic variables (i.e. heart rate, noninvasive blood pressure, oxygen saturation), and rescue analgesic requirements were recorded for 24 hrs postoperatively.
RESULTS: the onset of sensory and motor block was significantly faster in Group II compared to Group I (P <0.05). Rescue analgesic requirements were significantly less in Group II compared to Group I (P, 0.05). Haemodynamic variables did not differ between groups in the post-operative period.
CONCLUSION: Tramadol (2mg/kg) in combination with 38mL of Bupivacaine (0.25%) hastened onset of sensory and motor block, and improved postoperative analgesia when used in brachial plexus block, without producing any adverse events.
