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A DOUBLE BLIND COMPARISON OF EFFICACY OF ROPIVACAINE ALONE WITH TRAMADOL-ROPIVACAINE COMBINATION IN SUPRACLAVICULAR BRACHIAL PLEXUS BLOCK FOR UPPER LIMB SURGERY
ESRA Academy. Asad N. Sep 8, 2016; 138198
Topic: PROCEDURE BASED - EVIDENCE BASED RA AND PERIOPERATIVE ANALGESIA
Dr. Naila Asad
Dr. Naila Asad

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Abstract
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Background and Aims:

Ropivacaine, a long acting local anaesthetic, less toxic than bupivacaine  is now being used in peripheral nerve blocks. Most commonly adjuvants are used to enhance the quality and duration of anaesthesia and analgesia.

Objectives: The objectives of this study was to compare the effect of tramadol as adjuvant to ropivacaine on the quality, duration of anaesthesia and postoperative analgesia in supraclavicular brachial plexus block. 

Methods:

After written informed consent and approval of Instituitional Review Board, 60 patients of 25-60 years were randomly assigned into two groups of 30 each. Group I was given o.5% Ropivacaine 28 ml  with the addition of 2ml saline. Group II was given the same amount of 0.5% Ropivacaine with the addition of 2ml Tramadol (100mg). After aseptic measures supraclavicular brachial plexus block was administered and study drug was injected. Sensory and motor block were assessed at 5, 10, 15, 20 and 25 minutes. The degree of pain was assessed by VRS and postoperative pain was monitored at 1,2,4,8, and 12 hours. The first request analgesia time was noted.

Results:

The onset of sensory and motor block was not different in both groups. The duration of sensory and motor block were significantly prolonged in Group II (p=0.01, p=0.004). Pain scores were lower in Group II but there was no significant difference. Statistically significant difference was seen in the mean time to request for analgesia (p=0.03).
 

Conclusions:

Tramadol when used as an additive with ropivacaine provides better anaesthesia and analgesia in peripheral nerve block. 

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