Comparing the Efficacy of Bupivacaine Alone vs. Tramadol Plus Bupivacaine in Supraclavicular Brachial Plexus Block for Upper Limb Surgery

Abstract

Objective: To compare the onset of motor and sensory block, duration of analgesia, and respiratory and hemodynamic stability with tramadol as an adjuvant to bupivacaine in supraclavicular brachial plexus block in patients undergoing orthopedic upper limb surgery.

Study Design: Randomized controlled trial

Place and Duration: The trial was conducted in the Department of Anesthesia, Pain, and Intensive Care of Nishtar Hospital, Multan, from May 2017 to May 2018.

Methodology: The study was conducted on 80 patients, divided into two equal groups (I and II) by the lottery method. Variables assessed included gender, motor block (movement of hand), bradycardia, hypotension, nausea, vomiting, age, and VAS score. Data analysis was performed using SPSS version 23.

Results: The mean onset of sensory block, onset of motor block, duration of analgesia, and VAS score of patients in Group I were 18.37±1.99, 23.75±2.11, 270.75±2.99, and 7.37±1.04, respectively. In Group II, the mean onset of sensory block, onset of motor block, duration of analgesia, and VAS score were 17.67±2.32, 24.12±1.92, 466.03±4.11, and 4.97±1.34, respectively. The difference was statistically significant for the duration of analgesia (p=0.000) and VAS score (p=0.000).

Conclusion: Tramadol with bupivacaine in supraclavicular brachial plexus block prolongs analgesia, decreases postoperative pain, and shortens the onset of motor and sensory block. Tramadol does not affect hemodynamic stability.