A Comparative Study of Tramadol vs Butorphanol as an Adjuvant with Local Anaesthetic in Supraclavicular Brachial Plexus Block in Upper Limb Surgeries

Abstract

Brachial plexus block is a versatile and reliable regional anaesthesia technique. It is a block of roots, divisions and cords first performed by Halsted in 1884. It provides a useful alternative to general anaesthesia for upper limb surgery by being safe, decreasing the cost of anaesthetic agents, decrease operation theatre pollution and prolonged post-operative pain relief. Objectives: To study comparative effect of adding tramadol and butorphanol as an adjuvant with local anaesthetic (bupivacaine + xyloadrenaline ) in supraclavicular brachial plexus block in upper limb surgeries. Methods and Material: 60 patients were divided into two groups: Group A: inj. bupivacaine 0.5% (15ml)+inj xyloadrenaline (15ml) +inj tramadol(100mg) 2ml+inj ns 3 ml. Group B: inj. bupivacaine 0.5% (15ml)+inj xyloadrenaline (15)ml +inj butorphanol (1mg)1ml + inj ns 4ml. Assessment of onset of sensory and motor blockade, surgical procedure and duration of surgery. Perioperative complications were recorded and managed accordingly. Results: The onset of sensory block was rapid with Tramadol (4.2 min) as compared to Butorphanol (18.83min). The onset of motor blockade was faster with Tramadol (7.7min) as compared to Butorphanol (24.13min). Tramadol has longer duration of sensory (634.66 min) and motor (458.33 min) blockade as compared with butorphanol group (282.03min) and (350.16min) respectively (p<0.05). Duration of surgery and VAS Score was also similar in both groups and statistically not significant. Conclusion: Tramadol greatly reduce the onset time for sensory and motor block as well prolong the sensory and motor block,while Butorphanol has minimal effect on onset and duration of block but it provide post op analgesia.