Comparative study between tramadol and dexamethasone as an adjuvant to bupivacaine in supraclavicular brachial plexus block

Abstract

: Brachial plexus block is widely used as an efficient and cost effective alternative to general anesthesia for upper limb surgeries. A variety of adjuvants to local anesthetics have been used and compared, however, drugs which prolong the duration of anaesthesia and analgesia are being constantly studied for patient satisfaction and cost effectiveness.: Prospective, Interventional, Randomised study was conducted over 105 patients scheduled for elective upper limb surgeries under brachial plexus block, who were randomly allocated into three groups of 35 patients each. Group I- Bupivacaine with Tramadol, Group II- Bupivacaine with Dexamethasone and Group III- Bupivacaine alone. The time of onset and duration of sensory and motor block was noted. Hemodynamic variables were measured from baseline until the use of first rescue analgesic. The statistical analysis was done using SPSS (Statistical Package for Social Sciences) version 15.0 statistical analysis software.: Onset of sensory and motor blockade was significantly earlier in Group II (9±1.83 min) and (14.14±3.53min) as compared to Group I (11.94 ±2.59min) and (22.86±3.70min) and Group III(19±5.26min) and (27.14±4.07min). The requirement of first rescue analgesic was significantly earlier in Group III patients (211.43±23.25 min) followed by Group I (397±20.15 min) and last in Group II (632.43±23.15 min).: Bupivacaine with Dexamethasone provided an early onset of sensory and motor blockade with maximum duration of blockade requiring rescue analgesic at a much later time period compared to Bupivacaine with Tramadol and Bupivacaine alone when used in supraclavicular brachial plexus block.